Legionnaires' disease at autopsy

Sporadic deaths from Legionnaires' disease may escape detection at autopsy. Known epidemiological and clinical features of the disease should arouse suspicion and prompt appropriate bacteriological studies. The pathological findings in Legionnaires' disease are almost entirely confined to the lungs and are not distinct from any other severe bacterial bronchopneumonia. The causative organism, Legionella pneumophila, is difficult to identify on a Gram stain but will stain nonspecifically with the Giemsa, Warthin-Starry, and Dieterle techniques. The direct fluorescent antibody method allows specific identification of Legionella in paraffin-embedded tissue sections.     

Barriers to successful treatment completion in child sexual abuse survivors

Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental health treatment. Objective: (a) to describe characteristics between CSA patients who engage versus those who do not engage in mental health treatment and (b) to identify factors associated with successful completion of mental health treatment goals. For design/setting, a retrospective cohort study was conducted of CSA patients (ages 3-16 years) referred to mental health services following a CAC assessment. Outcome variables included linkage with treatment and completion of treatment. Independent variables included demographics, abuse characteristics, and therapist characteristics. Data were abstracted from the CAC and billing databases. Results: Four hundred ninety subjects were evaluated. Subjects were as follows: predominately female (74%), White (60%), and more than half received Medicaid (56%). Mean age was 8.4 years. About 52% linked with mental health services and 39% of patients that successfully linked with mental health services completed therapy. Successful linkage was independently associated with referrals to other counseling services (AOR 8.4 [2.5, 27.7]). Successful completion of therapy was independently associated with caregiver participation in therapy (AOR 3.2 [1.8, 6.0]) and if the patient was referred to other counseling services (AOR 4.1 [1.9, 8.5]). There were no differences between subjects that linked and/or completed therapy and those that did not with regard to demographic characteristics or abuse severity. Conclusion: In contrast to previous reports, efforts at our CAC seem to overcome linkage barriers in this population. However, there remain challenges in achieving successful completion of treatment goals in this population. Engaging caregivers' involvement in therapy services had a positive effect with successfully achieving treatment goals.     

A Nation of Immigrants or a Nation of Immigrant Cities? The Urban Context of Australian Multiculturalism, 1947–2011

The article documents the urban dimension of Australia's immigration experience that, since the 1940s, has seen the country become one of the world's most multicultural societies. The article argues that the greatest impact of immigration has been in the major cities, especially Sydney and Melbourne, which in recent decades have emerged as internationally‐significant immigrant hubs that, like similar immigrant‐receiving destinations across the globe, are increasingly demographically and culturally distinct from their host nation. Drawing on census materials, oral history interviews, local newspapers and other sources, we chart the demographic transformation of urban Australia from the 1940s to the present day and suggest that these changes have implications for how urban Australians — especially those resident in the two biggest cities — will understand and represent themselves and the nation into the future.     

Major depression – a study on the validity of clinicians’ diagnoses in medicolegal assessment

Major depression ranges among the most frequently diagnosed psychiatric disorders. Accordingly, diagnoses of depression are often underlying insurance, compensation or disability claims. This report evaluates the validity of clinicians’ diagnoses of major depression in a sample of claimants. In 2015, n = 127 consecutive cases were examined for medicolegal assessment. For all of them, a diagnosis of major depression had been established by clinicians. All testees underwent a psychiatric interview, a physical examination, they answered questionnaires for depressive symptoms according to DSM-5, embitterment disorder, post concussion syndrome (PCS) and unspecific somatic complaints. Performance and symptom validity tests were administered. Only 31% fulfilled the diagnostic criteria for DSM-5 major depression according to self-report, while none did so according to psychiatric assessment. Negative response bias was found in 64% of cases, feigned neurologic symptoms in 22%. Symptom exaggeration was indiscriminate rather than depression-specific. By self-report, 64% of the participants qualified for embitterment disorder and 93% for PCS. In conclusion, clinicians’ diagnoses of depression seem often confounded by improper assessment of the diagnostic criteria, confusion of depression with bereavement or embitterment and also by response bias.     

Offending histories and offending behaviour: A Ten year follow-up of sex offenders tried by Sheriff and District Courts in Grampian,Scotland

From criminal complaint records all incidents of sexual misbehaviour resulting in charges in three North East Scotland courts during 1981 and 1982 were traced. Of the 80 alleged offenders, 75 were followed up for 10 years using current criminal records.

Offending behaviour ranged from obscene telephone calls to rape. Half the offenders made no physical contact with their victims. These “hands-off” offenders were compared with “hands-on” offenders and were found to show a higher prevalence of sexual convictions both before the index offence and in the follow-up period. Those offenders who removed their victims clothes or had sexual intercourse with their victims were found to have the lowest prevalence of sexual reoffending. Degree of intrusiveness was inversely related to sexual recidivism in this sample and there was no evidence of progression over time to more intrusive offending.     

Failed Arbitrations before the Court of Common Pleas: Cases Relating to London and Londoners, 1400–1468

This article uses data gathered by the University of London, Centre for Metropolitan History's recent project ‘Londoners and the Law: Pleadings in the Court of Common Pleas’, which sampled London-related cases pleaded before the fifteenth-century court of Common Pleas, to analyze the use of arbitration by sub-gentry and mercantile class disputants. It examines the relationship between arbitration and litigation at common law, the volume of London-related cases pleaded at common law which cited a prior failed arbitration, and in what types of disputes arbitration was employed. It presents the hypothesis that the use of arbitration by sub-gentry and mercantile class disputants in cases relating to London and Londoners may have declined between 1400 and 1468, and that arbitration was most widely used in certain types of multifaceted and exceptional disputes. This article tentatively suggests that developments in disputants' use of common law remedies may have related to changes in the frequency with which arbitration was employed, calling for further study.     

‘Cracking collaboration’ between NGOs and academics in development research

This note argues that NGOs and academics are increasingly being pushed to collaborate by their respective ‘impact’ agendas. And a growing number of individuals who traverse both worlds are advocates for a much closer relationship to facilitate the theory-data interaction that lies at the heart of knowledge creation in international development. But different cultures and institutional constraints create challenges in making this collaboration work. A number of practical pointers are outlined for overcoming these obstacles, arguing that keeping the ultimate beneficiaries in focus is the best foundation for constructing a shared agenda in development research.

« Résoudre la collaboration » entre les ONG et les universitaires dans la recherche en matière de développement

Cette note soutient que les ONG et les universitaires sont de plus en plus incités à collaborer par leurs ordres du jour liés à l'« impact » respectifs. Et un nombre croissant d'individus qui appartiennent aux deux milieux préconisent une relation beaucoup plus étroite afin de faciliter l'interaction théorie-données qui est au centre même de la création de connaissances dans le développement international. Mais les cultures différentes et les contraintes institutionnelles engendrent des difficultés au moment d'assurer le bon fonctionnement de cette collaboration. Un certain nombre de conseils pratiques sont proposés pour surmonter ces obstacles, et on soutient que la meilleure fondation pour la construction d'un ordre du jour commun dans la recherche pour le développement consiste à garder en tête qui sont les bénéficiaires.

Resolviendo las dificultades a nivel de la colaboración entre ong y académicos en la investigación para el desarrollo

La presente nota sostiene que, cada vez más, las ong y los académicos son impulsados a colaborar entre ellos debido a sus respectivas agendas de “impacto”. Asimismo, un creciente grupo de personas que conoce ambos ámbitos aboga por el establecimiento de una relación aún más estrecha, a fin de facilitar la interacción entre teoría y realidad, meollo de la creación de conocimientos en el ámbito del desarrollo internacional. Sin embargo, las diferentes culturas y las limitantes institucionales generan impedimentos para el funcionamiento de dicha colaboración. El artículo establece un bosquejo de ayudas prácticas que posibilitarían eliminar dichos impedimentos, sosteniendo que mantener presentes a los beneficiarios últimos constituye el mejor cimiento para la construcción de una agenda compartida en el ámbito de la investigación para el desarrollo.

“Colaboração com fissuras” entre ONGs e acadêmicos na pesquisa sobre desenvolvimento

Esta nota argumenta que as ONGs e os acadêmicos estão cada vez mais sendo pressionados para colaborar através de suas respectivas agendas de “impacto”. E um número crescente de indivíduos que atravessam ambos os mundos são defensores de uma relação muito mais próxima para promover a interação entre teoria-dados que permanece no centro da criação de conhecimento no desenvolvimento internacional. Mas diferentes culturas e restrições institucionais criam desafios para a realização desse trabalho de colaboração. Vários indicadores práticos são apresentados para se superar esses obstáculos, argumentando que manter em foco os beneficiários finais é a melhor base para construirmos uma agenda compartilhada na pesquisa sobre desenvolvimento.     

The development of a sexual abuse severity score: characteristics of childhood sexual abuse associated with trauma symptomatology, somatization, and alcohol abuse

Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with self-reported trauma, somatization, and alcohol use. Characteristics included age of first sexual abuse, more than one perpetrator, degree of coercion, severity of abuse (i.e., attempted intercourse is more severe than fondling), and the number of occurrences. This is one of the few reports to develop a risk summary that quantifies the severity of CSA.