MI Implementation in Juvenile Justice: A Case Report

Motivational interviewing (MI) is a communication style focused on enhancing clients’ own motivation towards change. In the justice system MI has evidence to support that it enhances communication and change behaviors in youth. As most MI training is designed for healthcare settings training and implementation of MI must be adapted to fit the juvenile justice model. This includes both rehabilitation and restorative justice. Here we describe the details that allowed one county small county in Pennsylvania to roll out MI training and initial skills review in less than 6 months. The case reviews the details of planning, trainings, and timing of activities. We then discuss what elements of those details fit into a greater implementation plan that may be applied elsewhere. Four key elements were instrumental to implementation: 1) appreciation of JPO time constraints, 2) cost containment 3) using blending to enhance JPO flexibility with MI use, and 4) policies that normalize use of MI. This outline may assist other courts in their own implementation efforts.     

Factors Associated with Physician Discussion of Health Behaviors with Adolescents

Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of health behaviors with overweight and non-overweight adolescents and identify demographic and health behaviors related to exercise, hours of television viewing, and weight issues associated with these discussions. A Cross sectional survey of urban adolescents was conducted. Trained interviewers administered surveys over a three month period in 2001 at an urban academic pediatric and adolescent clinic. The 252 adolescents surveyed had a mean age of 15 with 49% categorized as being at risk for overweight/overweight and 51% as normal weight using the CDC percentiles for BMI. While 16% of the adolescents reported that their physician or nurse discussed the amount of television they watched, rates of discussion related to exercise (58%), and weight (54%) were much higher. In multivariate analyses, health care provider discussions with adolescents regarding exercise were more common for overweight (O.R.=2.42, 95% C.I. [1.28–4.57]) and at risk for overweight (O.R.=1.98, 95% C.I. [1.03–3.81]) adolescents, whereas physician discussion of television viewing was not associated with weight. Discussions of weight were more common for female (O.R.=2.18, 95% C.I. [1.21–3.95]), African-American (O.R.=2.53, 95% C.I. [1.40–4.57]), and overweight (O.R.=3.92, 95% C.I. [1.97–7.81]) adolescents. Even after adjusting for weight, race and gender strongly influenced the frequency of discussions about weight in physician offices. Although health care providers frequently address weight and exercise with adolescents, more discussions related to sedentary behaviors such as television viewing may be warranted to address adolescent obesity.Received PhD in Epidemiology from University of California, San Diego. Research interests include smoking prevention and cessation among adolescents and health promotion interventions.Received MD from University of Missouri-Kansas City and MPH from Johns Hopkins University. Research interests include health services research and research in support of measurable, systematic improvements in the quality of medical care.Received medical degree from Christian Medical College, Punjab, India and Master of Public Health from University of Kansas School of Medicine. Research interests include diet and physical activity behaviors, role of the environment in obesity and obesity prevention, especially among children and adolescents.Received MBBS from Allama Iqbal Medical College, Punjab University, Lahore, Pakistan and MPH from University of Kansas Medical Center. Research interests include smoking cessation, database design, implementation, data management and analysis, and use of information technology in health care settings.Director, Cancer Prevention, Control, and Population Sciences, Kansas Cancer Institute. Received MD/MPH from Tulane University and MS from Harvard School of Public Health. Research interests include disparities in healthcare; smoking cessation among underserved populations, specifically African Americans; diet, nutrition, obesity, and physical activity.     

Genetic diversity and forensic evaluation of 10 STR loci in Lodz region of Poland

Allele frequency data and forensic efficiency parameters for 10 STR loci: D3S1358, vWA, D16S539, D2S1338, D8S1179, D21S11, D18S51, D19S433, TH01 and FGA, were estimated from a sample of 207 unrelated individuals in Lodz region of Poland.     

Population data of nine Y-chromosomal STR loci in northern Poland

Allele and haplotype frequencies of nine Y-chromosome STR loci were determined from a sample of 508 unrelated males from north Poland. Three samples containing insertion polymorphism DYS19 (duplication) and DYS385I/II (triplications) were observed.     

Learning, multiple equilibria, and the state: Agriculture’s role

This article will argue that the state must learn to pursue productivity enhancing rather than predatory policies if rapid long-run development is to occur in poor countries. These productivity enhancing strategies will most likely involve investment coordination. However, such coordination of investment in manufacturing is likely to fail in less developed countries as a result of low productivity in the traditional, agricultural sector. More importantly, investment coordination in agriculture is more likely to be successful especially if this is a broad based investment strategy involving the bulk of the population. In this context, the state will learn effective policies for coordinating development. Alternatively, if the agricultural sector is ignored and productivity here remains low, investment coordination in manufacturing will likely fail, and the state will learn to become a predator. Richard Grabowski is professor of economics at Southern Illinois University-Carbondale     

Detection of deception with fMRI: Are we there yet?

A decade of spectacular progress in functional magnetic resonance imaging (fMRI) technology and systems neuroscience research has so far yielded few changes in our daily lives. The dearth of clinical applications of this prolific and academically promising research tool began raising the eyebrows of the public and the research funding agencies. This may be one of the reasons for the enthusiasm and interest paid to the growing body of literature suggesting that blood oxygenation level‐dependent (BOLD) fMRI of the brain could be sensitive to the differences between lie and truth. The word ‘differences’ is critical here since it refers to the often‐ignored core concept of BOLD fMRI: it is only sensitive to differences between two brain states. Thus, available studies report using fMRI to discriminate between lie and truth or some other comparative state rather than to positively identify deception. This nuance is an example of the extent to which applied neuroscience research does not lend itself to the type of over‐simplification that has plagued the interpretation of fMRI‐based lie detection by the popular press and the increasingly vocal academic critics. As an early contributor to the modest stream of data on fMRI‐based lie detection, I was asked by Dr Aldert Vrij to write a piece in favour of fMRI‐based lie detection, to be contrasted with a piece by Dr Sean Spence presenting an opposite point of view ( Spence, 2008 ). This seemingly straightforward task presented two hurdles: having to respond to the popular as well as scientific view of what lie detection with fMRI is and present a wholly positive view of evolving experimental data.     

"Legal highs"-Toxicity in the clinical and medico-legal aspect as exemplified by suicide with bk-MBDB administration

The easily available "legal highs", which are products containing psychoactive substances, such as cathinones, piperazines and synthetic cannabinoids, are abused by adolescents in Poland and in the world as alternatives to classic drugs, such as amphetamines or marijuana. The majority of these potentially dangerous substances are still legal and they are associated with a risk of severe poisoning or even death, and provide new challenges in clinical and forensic toxicological practice. Investigations in the field of "designer drugs" may be well illustrated by the case of a suicide of a 21-year old male who ingested a specified dose of a preparation called "Amphi-bi-a" that contains bk-MBDB, chemically 2-methylamino-1-(3,4-methylenedioxyphenyl) butan-1-one, which belongs to the cathinone group, as a synthetic euphoric empathogen and psychoactive stimulant that is chemically similar to MDMA. It is one of more common components of "legal highs" examined in Poland and other countries. The documentation of the case includes a clinical assessment of the patient's health status performed during his almost 4-h hospitalization before death, autopsy and histological examinations supported by toxicological findings revealing bk-MBDB at extremely high concentrations (at 20mg/l in the blood and 33mg/kg in the liver); hence, this body of evidence contributes to knowledge in the field of "designer drugs". Inventions of designers of new psychoactive xenobiotics, which are much in demand, especially in view of the dynamic Internet marketing, which drums up narcobusiness, must be balanced by a national strategy developed by medical, legal and educational circles in the modern civilized world in order to prevent the spreading of the phenomenon.     

An unusual case of high-voltage electrocution of a truck driver due to inadvertent contact of the truck with an overhead wire

Electrocution deaths are mostly accidental. However, reconstruction of events in unusual electrocution death is challenging. This article reports an accidental death due to electrocution in a highly unusual circumstance, in which a truck driver reversing his vehicle was electrocuted when his truck inadvertently touched an overhead high-voltage wire. The electric injury marks were present over the sole of the right foot. The scene investigation revealed that the high-voltage wire was loose and was below the level of the prescribed height. The truck was passing over an elevated area made up of dirt and stone. The interior of the cabin of the truck revealed a few non-insulated metallic areas over the floor of the truck, between the accelerator and the brake, which were attributed as the sources of entry of electricity into the body. The electric injury marks were different than those usually seen in high-voltage electrocution as there was an intermediate object (truck) involved, and the contact period between the truck and the electric wire was minimal. This fatality was attributed to the non-proper insulation of the interior of the truck, the negligent driving of the truck driver over the elevated surface, and the loose high-voltage wire without proper maintenance.     

Detection of Denatonium Benzoate (Bitrex) Remnants in Noncommercial Alcoholic Beverages by Raman Spectroscopy

Illegal alcoholic beverages are often introduced into market using cheap technical alcohol, which is contaminated by denatonium benzoate (Bitrex) of very small concentration. Bitrex is the most bitter chemical compound and has to be removed before alcohol consumption. The home‐made methods utilize sodium hypochlorite to disintegrate particles of denatonium benzoate in alcohol and to remove bitter taste before trading. In this experimental studies, we propose a novel method that detects in a fast way the remnants of denatonium benzoate in dubious alcohol samples by Raman spectroscopy. This method applies a portable Raman spectrometer of excitation wavelength 785 nm and utilizes the effect of surface‐enhanced Raman spectroscopy (SERS) to recognize the suspected alcoholic beverages. High effectiveness (over 98%) of YES/NO classification of the investigated samples was observed when the nonlinear algorithm support vector machine (SVM) was exploited at carefully adjusted detection parameters. The method can identify illicit alcohol within minutes.