Rapid assessment of existing HIV prevention programming in a community mental health center

In preparation for implementation of a comprehensive HIV prevention program in a Community Mental Health Center for persons with mental illness who are also abusing substances, a rapid assessment procedure (RAP) of existing prevention services that may have developed in the setting over time was undertaken at baseline. In addition to an ecological assessment of the availability of HIV-related information that was available on-site, in-depth interviews and focus groups were conducted with Center administrators, direct-care staff, and mental health consumers. Results indicated that responses regarding available services differed depending upon type of respondent, with administration reporting greater availability of preventive programs and educational materials than did direct-care staff or mental health consumers themselves. But overall, formalized training on HIV prevention by case managers is extremely rare. Case managers felt that other providers, such as doctors or nurses, were more appropriate to deliver an HIV prevention intervention.     

Sudden infant death syndrome (SIDS)--standardised investigations and classification: recommendations

Sudden infant death syndrome (SIDS) still accounts for considerable numbers of unexpected infant deaths in many countries. While numerous theories have been advanced to explain these events, it is increasingly clear that this group of infant deaths results from the complex interaction of a variety of heritable and idiosyncratic endogenous factors interacting with exogenous factors. This has been elegantly summarised in the "three hit" or "triple risk" model. Contradictions and lack of consistencies in the literature have arisen from diverse autopsy approaches, variable applications of diagnostic criteria and inconsistent use of definitions. An approach to sudden infant death is outlined with discussion of appropriate tissue sampling, ancillary investigations and the use of controls in research projects. Standardisation of infant death investigations with the application of uniform definitions and protocols will ensure optimal investigation of individual cases and enable international comparisons of trends.     

Autopsy at 2 months after death: brain is satisfactorily preserved for neuropathology

Disclosure of neurological disorders by neuropathological examination may be one important aim of forensic autopsies. There are insufficient data on human brain tissue preservation after prolonged postmortem periods. Here, we describe neuropathological findings in a brain of a 77-year-old woman that was fixed at autopsy 2 months after death. The body had been stored in a cooling chamber at 3 degrees C temperature. Gross inspection of the brain was satisfactorily possible. Histomorphology was excellently preserved. Many histochemical and immunohistochemical stains allowed satisfactory neuropathological evaluation of brain tissue and the diagnosis of Alzheimer's disease. Nevertheless, some immunohistochemical stainings repeatedly yielded negative or suboptimal results. We conclude that neuropathological examination of human brain tissue extracted from the skull and fixed after prolonged body storage in a cool environment is feasible for forensic diagnosis of neurological disorders even several months after death. However, in such cases the significance of negative immunohistochemical staining results must be interpreted with caution.     

The Ethical Health Lawyer: An Empirical Assessment of Moral Decision Making

Writing in 1999, legal ethics scholar Brad Wendel noted that "[v]ery little empirical work has been done on the moral decision making of lawyers." Indeed, since the mid-1990s, few empirical studies have attempted to explore how attorneys deliberate about ethical dilemmas they encounter in their practice. Moreover, while past research has explored some of the ethical issues confronting lawyers practicing in certain specific areas of practice, no published data exists probing the moral mind of health care lawyers. As signaled by the creation of a regular column "devoted to ethical issues arising in the practice of health law" in the Journal of Law, Medicine & Ethics , the time to address the empirical gap in the professional ethics literature is now. Accordingly, this article presents data collected from 120 health care lawyers. Presenting this population with a number of hypothetical scenarios relating to how they would respond when confronting an ethical dilemma without an obvious solution or when facing a situation in which their personal values were in tension with their professional obligations, this article represents a first step toward better understanding how lawyers who practice in health care settings understand and resolve the moral discomfort they encounter in their professional lives.     

Perceived Justice of Compensation Process for Return-to-Work: Development and Validation of a Scale

The experience of injured workers is influenced by multiple systems—the workplace, the healthcare system, and the workers’ compensation system. Little research has been conducted on the impact of the workers’ compensation system on injured workers’ personal experience and on the justice of the workers’ compensation process. The purpose of this study was to develop and validate a measure of the justice of the compensation process. Injured workers (n?=?446) with musculoskeletal injuries, in Ontario, Canada, filing a lost-time claim, completed a telephone survey 6 months post-injury. Exploratory and confirmatory factor analyses were conducted with two separate samples, and concurrent validity was examined. The four hypothesized factors emerged: distributive justice, procedural justice, informational justice, and interpersonal justice factors accounted for 96.3% of the variance. Confirmatory factor analyses had satisfactory fit indices to confirm the initial model. Alpha coefficients ranged from 0.86 to 0.92. Concurrent validity of the scale was supported: relationships of distributive and procedural justice with claim status, claim processing delay, perception of going back to work too soon, duration of work accommodation, and satisfaction with work accommodation were in the expected direction. Workers’ experience of the justice of the compensation process can now be measured with a psychometrically sound and theoretically based instrument. This instrument offers researchers the opportunity to focus on the justice of the compensation process of injured workers. It can increase the attention that policy-makers, compensation management, healthcare providers, and other return-to-work stakeholders give to the impact of the compensation system and provide a broadened view of workers’ experience.     

Measuring the Frequency Occurrence of Handwritten Numeral Characteristics

The premise of this follow‐up sister study to “Measuring the Frequency Occurrence of Handwriting and Handprinting Characteristics” was to collect a representative population sampling of numerals and assess how many participants utilize each of the predetermined characteristics as found in their specimens. A total of 1410 handwriting specimen forms were collected from across the United States and pared to 1025 to obtain a proper representative sample of the U.S. adult population based on the same demographics used in the original 2017 study. This study provides frequency of occurrence proportions and 95% confidence limits for 25 handwritten numeral characteristics. A total of 277 intercharacter pairs of handwritten numeral characteristics were cross‐analyzed for interdependence. The results were that 72.92% of all intercharacter pairs had a coefficient of correlation between ?0.2 and +0.2 in this study.     

Trajectories of Substance Use Among Young American Indian Adolescents: Patterns and Predictors

Substance use often begins earlier among American Indians compared to the rest of the United States, a troubling reality that puts Native youth at risk for escalating and problematic use. We need to understand more fully patterns of emergent substance use among young American Indian adolescents, risk factors associated with escalating use trajectories, and protective factors that can be parlayed into robust prevention strategies. We used growth mixture modeling with longitudinal data from middle-school students on a Northern Plains reservation (Wave 1 N = 381, M age at baseline = 12.77, 45.6 % female) to identify subgroups exhibiting different trajectories of cigarette, alcohol, and marijuana use. We explored how both risk (e.g., exposure to stressful events, deviant peers) and protective (e.g., positive parent–child relationships, cultural identity) factors were related to these trajectories. For all substances, most youth showed trajectories characterized by low rates of substance use (nonuser classes), but many also showed patterns characterized by high and/or escalating use. Across substances, exposure to stress, early puberty, and deviant peer relationships were associated with the more problematic patterns, while strong relationships with parents and prosocial peers were associated with nonuser classes. Our measures of emergent cultural identity were generally unrelated to substance use trajectory classes among these young adolescents. The findings point to the importance of early substance use prevention programs for American Indian youth that attenuate the impact of exposure to stressful events, redirect peer relationships, and foster positive parent influences. They also point to the need to explore more fully how cultural influences can be captured.     

Striving for Educational and Career Goals During the Transition After High School: What is Beneficial?

The present study takes a motivational perspective that views youths’ educational and career engagement as influential and potentially competing for the same motivational resources in the transition to adulthood. We investigated whether motivational engagement with educational and career goals in the year after high-school graduation was differentially associated with educational, career-related and subjective well-being outcomes 2 and 4 years after school graduation. Our longitudinal study of a multi-ethnic sample of Los Angeles high-school graduates followed participants 2 years (N = 561; 61.5 % female) and 4 years (N = 364; 59.8 % female) after high school graduation. The findings indicate that motivational engagement with educational goals after high school graduation predicted educational attainments and psychological well-being at follow-up 2 and 4 years after graduation, and occupational progress at 4 years after graduation. Work hours assessed shortly after high school graduation were associated with poorer educational outcomes both at 2 and 4 years after high school. Occupational goal engagement was not associated with better outcomes, but predicted less educational attainment 4 years after graduating. Thus, educational goal engagement predicted favorable outcomes, whereas career-related goal engagement for the most part was neutral with some select associations with negative educational outcomes. A strong motivational commitment to educational goals, but not to career goals, is an important component of a successful transition to adulthood.     

The presence of absence: Beyond the “great goddess” in Ana Mendieta's Silueta Series

Ann Liv Young's The Bagwell in Me, which premiered at The Kitchen in NYC, 2008, continues this experimental dance-theater artist's characteristically brutal, anatomizing exposure of the performers’ bodies through both sexual and violent narratives. This analysis examines how Young's construction of a certain type of subject on the stage challenges the subjectivities of her audience members, provoking moments of potential eruption. By setting up the possibility of abjection through the ambivalent dynamic of attraction and repulsion, and bombarding the audience with tropes that engender a push toward Georges Bataille's concept of “radical formlessness,” I argue, Ann Liv Young's performance places notions of the stable subject – composed of a “whole” body that is coherently organized and intelligibly coded in terms of sex, gender, sexuality and race – into question. Not only will this analysis explore how viewing oral sex as choreography speaks to Bataille's discussion of radical formlessness through decontextualization and the maddening effects of staring at the sun, but it will also interrogate how the same strategy of radical formlessness could have entirely different performative effects regarding the threat of bodily coherence and taxonomy within the narrative of historical racial violence.