Family contexts of pubertal timing

This study examined the influence of pubertal timing upon family interactions in normal and psychiatric adolescent samples. An important feature of our approach is its emphasis upon micro-analysis of family behaviors (individual speeches) and family processes (theoretically specified speech pairings). Rather than assume that global family patterns (e.g., power) shift in response to pubertal changes, we follow how types of speeches and speech sequences are associated with different pubertal timing. Using the previously constructed family coding system, the Constrainig and Enabling Coding System, we found that on-time adolescents and their parents differed from both off-time groups (early or late). These results are discussed in terms of current implications and suggestions for future research.An earlier version of this paper was presented at the SRCD Study Group on Timing of Maturation, October, 1983, at the Education Testing Service, Princeton, NJ. This research was supported by NICHD Grant 1 R01 HD18684-01, and an NIMH Research Scientist Award (Dr. Hauser).Received his Ph.D. from Harvard University. Research interest is adolescent development within the family and impact of chronic illness on adolescent development and family interaction.Received her B.A. from Wellesley College. Research interests are in humor and attractiveness.Received his M.A. from Boston University. Research interests are in methodology and statistics.Received Ed.D. from Harvard University. Research interests are in adolescent development within the family, and family coping with stress.Received M.D. from University of Chicago. Research interests are in psychosocial aspects of diabetes.Received Ed.D. from Harvard University. Research interests are in developmental psychopathology, and moral and ego development.Received Ph.D. from Ohio State University. Research interests are in assessment of ego development and family systems.Received Ph.D. from University of Miami. Research interests are in family studies and adolescent development.     

Worries and Health in Adolescence: A Latent Variable Approach

In this study, the most salient worries of Dutch adolescents are examined and the most often reported symptoms are ranked. The relationship between worrying and health is explored using structural modeling as are the frequently found gender differences in these areas. Worrying is postulated as an indicator of psychosocial well-being along with affectivity, ease of parental communications, tiredness, and loneliness. Health, or physiological status, is indicated by reported symptoms, frequency of doctors visits, aspirin consumption, and a global health measure. Four hundred and sixteen high-school students (211 girls and 205 boys) fitted in a questionnaire during school hours. The structure of the bet fitting model was the same for boys and girls, indicating that gender differences are a question of degree, and not of different structural relationships. Psychosocial well-being explained 77% of the variance in physiological status. The implications of the findings for health education are discussed.     

Acute selenium poisoning: suicide by ingestion

Selenium is a ubiquitous element in the environment essential to the human diet and widely utilized in industrial processes. Fatal human selenium intoxication is rare. The authors report a case in which investigators recovered a bottle of gun-bluing agent beside a 24-year-old man. He exhibited signs and symptoms typical of acute selenium intoxication presenting with nausea and vomiting, followed by pulmonary edema and rapid cardiovascular collapse approximately 3 to 4 h after ingestion. Classic electrocardiographic (EKG) changes, which have been reported to occur in acute selenium intoxication, included sinus tachycardia with ST wave alteration. Toxicological results confirmed elevated blood and tissue concentrations. The cause of death was ascribed to acute selenium intoxication, which ensued rapidly after oral consumption. The manner of death was suicide. This case report, which presents an overview of acute and chronic selenium poisoning, underscores the value of thorough toxicologic analyses of tissue and body fluids in humans.     

Assessment and aftercare for deliberate self-harm patients provided by a general hospital psychiatric service

We report on a sample of 135 deliberate self-harm (DSH) patients who were assessed by a general hospital DSH service, and on those who were offered aftercare by, or telephone open access to, the service. Patients' satisfaction with assessment and treatment, and their outcome were investigated at follow-up 12-20 months later. Four-fifths of patients reported the assessment following DSH to have been helpful and the assessor sympathetic. Thirty-three (24%) of the 135 patients assessed were offered treatment by the DSH service but 13 declined or failed to attend. Of the 20 who engaged in treatment, 17 (94%) were satisfied with their care. Open access to the DSH service by telephone was offered to 53 (39%) patients, nine (22%) of whom reported at follow-up that they had used this facility. A specialist DSH service can effectively assess and treat patients following DSH. It is important that the service is accessible and acceptable to patients.     

Predicting successful outcomes for serious and chronic juveniles in residential placement

In the past decade, juvenile justice agencies have become more reliant on objective risk scales based on an actuarial approach to assessing risk. Risk assessment scales are used as decision-making guides at multiple points in the juvenile justice system. However, little research has focused on assessment of more serious offenders facing removal from the community. Enormous benefits can be derived, both in public safety and cost savings, from successful interventions with these offenders. Identifying offenders most amenable to intervention and at lowest risk for offending upon leaving placement represents a significant challenge. In this study, a placement risk screen was developed that assesses amenability to treatment in a residential treatment program and later risk for adult criminality. The relationship between suspected risk factors, success in a residential treatment program, and adult offending was assessed in a population of 81 male delinquent youths. Many factors are believed to have a bearing on success in treatment and later offending behavior, but only a small number of these were statistically significant. The results suggest that success in residential placement can reduce future offending, but that youth should first be screened for amenability to the program so scarce resources can be conserved. The proposed placement risk screen can assist juvenile court judges, officers, and residential treatment staff in identifying youth most suitable for treatment and who represent a lower risk to the community.     

Managing generic competition and patent strategies in the pharmaceutical industry

Legal context: The income streams of originating pharmaceutical manufacturersare under pressure as never before, from increasing R&Dcosts, regulatory pressures, and competition from generic manufacturers.This article examines the various strategies which originatingpharmaceutical manufacturers have adopted in response to thesethreats. Key points: The authors consider various strategies, including SupplementaryProtection Certificates, life-cycle management (‘evergreening’),second pharmaceutical use claims, trade marks, and the use ofdata exclusivity and interim injunctions, in order to prolongthe protection given to existing products, and to manage competitionfrom generic manufacturers. Practical significance: The authors also include two real-life case studies in orderto illustrate the practical applications of the strategies discussedin the article.     

Strengthening the Intergovernmental Grant System: Long-Term Lessons for the Federal–Local Relationship

This study investigates the longitudinal political and administrative problems associated with federal–local government relations. The findings demonstrate four primary challenges of the system of federal grants-in-aid that hinder the relationship of policy design at the federal level and policy implementation in local communities: the politics of decentralization, subnational capacity, program accountability and program adaptability. A case study of the Community Development Block Grant, as assessed by the Advisory Commission on Intergovernmental Relations and the General Accounting Office between 1974 and the present, is included to demonstrate the application of these problems within the system. Although the "evolution of devolution" can greatly benefit the recipients of public services at the local level, it often operates within an unorganized and ineffective system that public managers at all levels of government must continue to develop.