Regional variations in public opinion on the affordable care act

One year after passage, the Patient Protection and Affordable Care Act (ACA) remains a divisive topic. Most publicly released polls on the law have focused on the views of Americans as a whole. But with much of the responsibility of implementation lying with the states, this essay explores whether opinion differs geographically. The analysis finds that views on the health reform law do differ by region, and these differences are most likely driven by the political leanings of a given area. While opinion nationally differs by age and race, this pattern does not hold when looking by region. Areas that have a larger share of uninsured and are slated to receive greater federal funding under the ACA also do not differ in their opinions. These data suggest that regional variations in attitudes about the ACA are based less on the demographic structure of a region and more on the political ideologies of residents in a given region. As implementation of the law continues, this analysis shows that national opinion data mask important regional variations in views of the ACA.     

Development and validation of a liquid chromatography-tandem mass spectrometry assay for hair analysis of atomoxetine and its metabolites: Application in clinical practice

Atomoxetine (ATX) is a potent inhibitor of the noradrenaline reuptake transporter approved since 2002 for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults as alternative treatment to methylphenidate. A procedure based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) has been developed for the determination of ATX and its main metabolites (4-hydroxyatomoxetine - 4 hydroxyATX - and N-desmethylatomoxetine - des-methylATX) in hair of one treated child and five treated adolescents. Since hair samples can be easily collected without the need for specials skills and exposing a patient to discomfort, hair testing of ATX and eventually of its metabolites should be useful, especially in case of pediatric patients, to check compliance in a wider time-window. After addition of duloxetine as internal standard, hair samples were overnight digested with 2ml 1M NaOH at 45°C. Then, analytes were extracted from alkaline solution with two different 2ml aliquots of tert-butyl methyl ether. Chromatographic separation was achieved at ambient temperature using a reverse-phase column and a mobile phase of 40% of water-60% 5mM ammonium acetate, 50mM formic acid, 4mM trifluoroacetic acid in acetonitrile-water (85:15, v/v). The mass spectrometer was operated in positive ion mode using multiple reaction monitoring. The method was linear over the concentration range 0.2-50ng/mg hair for the all analytes under investigation, with an intra- and inter-assay imprecision and inaccuracy always less than 20% and an analytical recovery between 33.1% and 76.1%, depending on the considered analyte. Only ATX and 4-hydroxyATX were detected in hair samples with concentrations varying from 0.2 to 2.0ng/mg hair and from 0.3 to 1.0ng/mg, respectively. Notwithstanding the absence of any dose-hair concentration relationship, hair monitoring of ATX and concomitant medications commonly administrated in ADHD children and adolescents can be crucial in verifying long-term compliance to prescribed medication in individuals displaying a non negligible tendency to refuse drugs and to lie on the adherence to therapy as a specific symptom of the disease.     

The relationship of negative self-schemas and insecure partner attachment styles with anger experience and expression among male batterers

The purpose of the study was to explore how negative self-schemas and partner attachments were related to the experience and expression of anger (i.e., trait anger, inward and outward expression of anger) in a sample of male batterers (n = 40) who participated in court-mandated group services. They completed the Experience in Close Relationships (ECR), the Young Schema Questionnaire-2 (YSQ-2), the State-Trait Anger Expression Inventory-2 (STAXI-2), and a demographic sheet. Male batterers who experienced pervasive anger (i.e., trait anger) tended to experience negative self-schemas associated with the Impaired Limits domain (respecting the rights of others, insufficient self-control, entitlement). Male batterers who tended to suppress their anger tended to feel avoidantly attached to their romantic partner and endorsed negative self-schemas associated with the Disconnection and Rejection domain (abandonment, emotional deprivation, defectiveness/shame). Implications for clinical practice with male offenders and future research are discussed.     

Peer Consultation for Mediators: The Use of a Holding Environment to Support Mediator Reflection, Inquiry, and Self-Knowing

In order to help the parties in mediation address their interests, concerns, and responses to the conflict, the mediator must monitor and manage his or her own inner thoughts, emotions, and feelings throughout the process lest they negatively influence the outcomes of the mediation. Peer consultation offers one approach that can be used effectively to support the mediator's inquiry into practice dilemmas and invite self-knowing that benefits the mediator as well as the parties in the mediation. The effectiveness of a group consultation process, however, depends on the development of "a holding environment" that can provide a safe and confidential space within which such an inquiry can occur. The mediation process is improved when the mediator is able to sustain relational and emotional tension within herself and between the parties long enough for new understandings and actions to develop.     

A qualitative study of compact bone microstructure and nuclear short tandem repeat obtained from femur of human remains found on the ground and exhumed 3 years after death

Forensic identification of human remains is composed of anthropological study of race, sex, age, etc. By using these traditional methods, inconclusive or nonidentified cases could be subjected to DNA analysis. However, in spite of advances in human identification techniques, especially by PCR-amplified DNA, some limitations that affect the ability of obtaining DNA from human remains still persist. Light microscope sections of postmortem compact bones from human remains are presented here for the purpose of increasing a forensic examiner's prediction of successful nuclear DNA typing. Femoral compact bones were obtained from 7 human remains found on the ground, in different degrees of decomposition, and were cleaned by boiling to remove soft tissues, 8 collections of bones having undergone natural decomposition, not boiled (as no soft tissue was adhered), and 5 cadavers 12 to 16 hours postmortem. The histologic sections were stained by hematoxylin and eosin, the loci CSF1PO, TPOX, TH01, F13A01, FESFPS, vWA, D16S539, D7S820, D13S317, and amelogenin were amplified by PCR, and the polyacrylamide gel was stained with silver. The results presented here clarify questions concerning the viability of DNA for identification analysis, and they also may help to establish better strategies for optimization of DNA extraction and analysis in compact bones of human remains.