The role of beta-amyloid precursor protein (beta-APP) staining in the neuropathologic evaluation of sudden infant death and in the initiation of clinical investigations of subsequent siblings

This report highlights the importance of undertaking immunohistochemical staining of the brains of infants who die unexpectedly, as it may not only assist with the evaluation of the cause of death in an individual infant but may also help with the clinical management of subsequent siblings. A 5-month-old male infant who died suddenly was found to have diffuse beta-amyloid precursor protein (beta-APP) staining in the brain, with no unusual features in his history, death scene examination, routine autopsy dissection, and ancillary tests to suggest any definite cause of death. Due to the beta-APP staining, the possibility of previous episodes of occult trauma, apparent life threatening events (ALTEs), and accidental or inflicted suffocation was raised in the autopsy report. As detailed analyses and investigations provided no supportive evidence for trauma or inflicted injury, hypoxia was clinically considered the most likely cause. Because of these concerns, sleeping oxygen saturation levels were monitored following the birth of a subsequent sibling who had normal APGAR scores and no evidence of any health problems. Oxygen desaturation to 70% occurred in association with a color change while on the postnatal ward, and a subsequent polysomnogram showed multiple episodic significant desaturations to around 80% in association with central apnea. Other testing was unremarkable. These cases demonstrate that beta-APP staining of the brain may not only provide clues as to possible mechanisms of death in pediatric forensic cases but may indicate a need for careful clinical evaluation of subsequent siblings for possible central apnea requiring oxygen therapy.     

Tolerance and economic growth revisited: a note

Berggren and Elinder (BE) in this journal write on the relationship between the degree of tolerance in a nation and its rate of economic growth. They are disturbed to find in their cross sections that faster economic growth statistically goes together with intolerance of homosexuals. In this comment, we revisit the issue and demonstrate that the concern expressed by BE is unwarranted if we properly account for ??conditional convergence?? in the regressions for economic growth. Other things being equal, a country grows faster if it starts from a poorer initial position. In the BE dataset, China since the Deng reforms is a prime example. At about the same time, another group of countries managed to accelerate their economic growth after a long period of stagnation: the ex-communist countries in central and Eastern Europe. Many of these nations also grew exceptionally fast for a number of years, once freedom had been regained and the initial chaos overcome. With simple modeling of these historical initial conditions, we find no statistical pattern that associates bias against homosexuals with weaker economic growth. Our results are robust under alternative specifications.     

British Campaigns for Solidarity with Argentina and Chile

The Chile solidarity movement persuaded British Labour governments (1974–1979) to introduce a range of measures against the Pinochet regime. But campaigners lobbying against the Argentine dictatorship (1976–1983) had less impact on policy. Neither these Labour governments nor the subsequent Conservative government imposed any sanction on the Argentine dictatorship, until the invasion of the Falkland Islands. This article explores why in Britain – and Europe – the Chile campaign had greater public appeal than the Argentina solidarity campaigns. It identifies a number of common factors across Europe which explain why the anti-Pinochet cause generated more support than the Argentina campaign.     

Regional and multi-level governance: East Asian leadership after the global financial crisis

Although the economies of East Asia emerged from the global financial crisis of 2008 in comparatively strong positions, they remain structurally embedded within global markets. The degree of regional integration that has occurred within East Asia is thus predicated on the on-going interdependence with the economies of Europe and North America. Moves to advance East Asian regional cooperation in the wake of the crisis reflect this global interdependence, as well as intra-regional differences in interests and a lack of strong leadership within the region. Modest cooperation on an East Asian basis has continued since 2008 but the region is very far from realising a substantive regional governance model on economic and financial issues and does not appear to be pursuing a distinctive governance agenda. This article examines recent developments in East Asian regional cooperation, with a view to assessing the significance of current achievements and explaining the mixed and sometimes contradictory nature of initiatives for regional governance in East Asia.     

Initial Findings from a Feasibility Trial Examining the SafeCare Dad to Kids Program with Marginalized Fathers

Few studies have explored the direct impact of behavioral parent training programs on child maltreatment behaviors among marginalized, at-risk fathers. This feasibility study examined SafeCare® Dad to Kids (Dad2K), an augmented version of the evidence-based child maltreatment prevention program SafeCare, to determine the acceptability and initial efficacy of the program for improving father parenting skills and reducing maltreatment risk. Ninety-nine fathers were enrolled in the study and randomized to the SafeCare Dad2K Intervention (n?=?51) or comparison (n?=?48). Intervention fathers participated in 6 home visiting sessions and comparison fathers received parenting materials via mail. All fathers participating in the study completed a baseline and 8-week assessment (post-intervention) of maltreatment behaviors. In addition, intervention fathers completed feasibility and parenting skill measures. A significant main effect emerged indicating decreases for both groups in psychologically aggressive behaviors. No significant group by time findings emerged for child maltreatment behaviors. Father intervention completers endorsed high satisfaction ratings for the program and demonstrated significant improvements in targeted father-child interaction skills. Based on the high rates of acceptability and initial improvement in positive parenting skills, findings demonstrate the feasibility for involving at-risk fathers in behavioral parent training programs targeting child maltreatment prevention.     

Motivation in humanitarian health workers: a self-determination theory perspective

This paper emerged from the authors' interest in why humanitarian health workers initially engage and remain in humanitarian work, often in the face of threats to safety and personal well-being. Semi-structured qualitative interviews assessed the consciously available reasons why individuals engaged in humanitarian health work. Interview data was unpacked through a thematic analysis. Using self-determination theory as a guiding framework, data suggested introjected and identified motivations are applicable to this occupational domain. Introjected motivation is implicated in initial reasons to engage the work, while identified motivation is implicated in reasons to continue. Theoretical and practical implications of these findings are discussed.

Motivation parmi les travailleurs humanitaires dans le domaine de la santé : un point de vue basé sur la théorie de l'autodétermination

Cet article a émané de l'intérêt de l'auteur concernant les raisons pour lesquelles les travailleurs humanitaires dans le domaine de la santé s'engagent initialement et continuent de travailler dans l'humanitaire, souvent malgré les menaces qui pèsent sur leur sécurité et sur leur bien-être personnel. Des entretiens qualitatifs semi-structurés ont permis d'évaluer les raisons consciemment disponibles qui expliquent que certaines personnes se soient engagées dans le travail humanitaire dans le domaine de la santé. Les données obtenues grâce aux entretiens ont été examinées au moyen d'une analyse thématique. En prenant la théorie d'autodétermination comme cadre d'orientation, les données ont suggéré que des motivations introjectées et identifiées sont applicables à ce domaine professionnel. La motivation introjectée intervient dans les raisons initiales de s'engager dans ce type de travail, tandis que la motivation identifiée intervient dans les raisons de continuer. Les implications théoriques et pratiques de ces conclusions font l'objet d'une discussion.

Motivação para Trabalhadores Humanitários da Área da Saúde: Uma Perspectiva da Teoria da Auto-Determinação

Este artigo surgiu do interesse dos autores em saber por que os trabalhadores humanitários da área da saúde engajam-se inicialmente e depois permanecem no trabalho humanitário, frequentemente enfrentando ameaças à segurança e bem-estar pessoal. Entrevistas qualitativas semiestruturadas avaliaram as razões dos indivíduos engajarem-se no trabalho humanitário na área da saúde, razões estas conscientemente apresentadas. Dados da entrevista foram processados através de uma análise temática. Utilizando a teoria da auto-determinação como estrutura de orientação, os dados sugeriram que as motivações introjetadas e identificadas são aplicáveis a este domínio ocupacional. A motivação introjetada está associada às razões iniciais de se engajar no trabalho, enquanto a motivação identificada está associada às razões de se permanecer no trabalho. As implicações teóricas e práticas destes resultados são discutidas.

La motivación en los trabajadores humanitarios de salud: una perspectiva de la teoría de la autodeterminación

Este ensayo surgió del interés de los autores en cómo los trabajadores humanitarios de salud inician su trabajo y permanecen en él a pesar de las frecuentes amenazas a su seguridad y bienestar personal. Las entrevistas cualitativas semiestructuradas realizadas revelaron las razones enunciadas conscientemente de porqué los individuos participan en el trabajo humanitario en salud. Se evaluaron las entrevistas a través de un análisis temático. Utilizando la teoría de la autodeterminación como marco, las entrevistas sugieren la existencia de motivaciones tanto introyectadas como identificadas en este ámbito de trabajo. La motivación introyectada se refiere a las razones para iniciar el trabajo y la motivación identificada a las razones para seguir en él. El ensayo examina las implicaciones teóricas y prácticas de estos resultados.     

Mentally ill offenders eligible for diversion at local court in New South Wales (NSW), Australia: factors associated with initially successful diversion

Diversion away from the criminal justice system and into mental health treatment services is a key strategy for addressing the well-established burden of mental illness suffered by those presenting to court. While mental health courts, court liaison and court diversion services have been developed in many jurisdictions internationally, there is limited research evidence to support their effectiveness in identifying those with mental health need and achieving successful diversion. The Statewide Community and Court Liaison Service in New South Wales, Australia, identifies mentally ill offenders likely to meet legal eligibility criteria for diversion at the busiest local courts across the state. Utilising data collected by mental health clinicians working in the service, 8317 individuals were identified as being eligible for court diversion on at least one occasion during the study period (1 July 2008 and the 30 June 2015) and 57.3% were subsequently diverted by Magistrates. Successful diversion at this first step was associated with being female, older, of non-Aboriginal and/or Torres Strait Islander background, and having a serious mental illness, replicated when stratified by sex and by Aboriginal and/or Torres Strait Islander background. There may be barriers to mental health diversion at court for individuals with particular socio-demographic characteristics which future service developments may need to take into account.     

Parenting interventions for incarcerated parents to improve parenting knowledge and skills,parent well-being,and quality of the parent–child relationship: A systematic review and meta-analysis

Objectives

To systematically review and quantitatively synthesize the evidence for the impact of parenting interventions for incarcerated parents on parenting knowledge and skills, parent well-being, and quality of the parent–child relationship.

Methods

A systematic search of 19 published and unpublished literature sources was conducted between June and July 2015 (with no date, language, document type, or geographical restrictions). Studies were included if they: (a) utilized a sample of parents who completed a parenting intervention in an incarceration setting; (b) measured parenting knowledge and skills, parent well-being, or quality of the parent–child relationship as outcome measures; and (c) employed a randomized controlled trial or quasi-experimental design with no treatment, waitlist control, or treatment-as-usual as the comparison condition. Two review authors independently determined study eligibility and extracted data from eligible studies, which included rating the risk of bias for each eligible study. Meta-analysis was used to synthesize standardized effect sizes, and subgroup analyses were used to examine the moderating effect of parent gender, level of child involvement, and research design.

Results

Twenty-two studies were eligible for inclusion in the review; however, only 16 studies (N = 2292) reported sufficient data for inclusion in the meta-analyses. Parenting interventions were more effective at post-intervention for improving parenting knowledge and skills than no treatment, waitlist control, or treatment-as-usual [standardized mean difference (SMD) = 0.68, 95% confidence interval (CI) 0.28, 1.06] and quality of the parent–child relationship (SMD = 0.27, 95% CI 0.02, 0.51), but not for improving parent well-being (SMD = 0.14, 95% CI ?0.03, 0.30). There was significant heterogeneity across effect sizes for both parenting knowledge and skills and quality of the parent–child relationship outcome domains. There were no statistically significant differences between subgroups, and the effectiveness of parenting interventions was not maintained at follow-up time-points.

Conclusions

Existing evidence suggests small to moderate effectiveness for parenting interventions during incarceration at close to intervention completion. Further methodologically robust research is required to more confidently establish the effectiveness of parenting programs both in the short-term and in the post-release period.