Epidemiology of Suicide Attempts among Youth Transitioning to Adulthood

Suicide is the second leading cause of death for older adolescents and young adults. Although empirical literature has identified important risk factors of suicidal behavior, it is less understood if changes in risk factors correspond with changes in suicide risk. To address this knowledge gap, we assessed if there were different trajectories of suicidal behavior as youth transition into young adulthood and determined what time-varying risk factors predicted these trajectories. This study used four waves of data spanning approximately 13 years from the National Longitudinal Study of Adolescent Health. The sample included 9027 respondents who were 12–18 years old (M?=?15.26; SD?=?1.76) at Wave 1, 50% male, 17% Hispanic, and 58% White. The results indicated that 93.6% of the sample had a low likelihood for suicide attempts across time, 5.1% had an elevated likelihood of attempting suicide in adolescence but not young adulthood, and 1.3% had an elevated likelihood of attempting suicide during adolescence and adulthood. The likelihood of a suicide attempt corresponded with changes on depression, impulsivity, delinquency, alcohol problems, family and friend suicide history, and experience with partner violence. Determining how suicide risk changes as youth transition into young adulthood and what factors predict these changes can help prevent suicide. Interventions targeting these risk factors could lead to reductions in suicide attempts.     

Space Traffic Management at the National and International Levels

The number of objects in Earth’s orbit has continued to grow since the space race between the United States and the Soviet Union. The historical “few objects, large space” principle left satellite operations a relatively benign environment, but that construct has shifted significantly due to the advent of the commercial space sector, the small satellite industry boom, and the resurgence of the desire for human space flight. The regulations for space operations both at the international and national level have always been sparse, but there is a large desire for more now that commercial capital is at stake. The purpose of this article is to bring to the surface available regulations for on-orbit operations to identify the gaps to fill and highlight the change for the Department of Defense. The international community and commercial sector recognize the need for a state like the United States to set a standard to influence the international community. This national-to-international framework is a technique used in other arenas, such as maritime traffic management and air traffic management, and the lessons learned from these fields are applicable to the space domain.     

Self-rated health and barriers to healthcare in Ukraine: The pivotal role of gender and its intersections

The ongoing health crisis in the Ukraine has persisted for 48 years with a clear division of gender-based outcomes as seen in the decline of male life expectancy and stagnation of female longevity. The purpose of this paper is to investigate differences in self-rated health and system barriers to health care applicable to gender and its intersections because of the differing negative health outcomes for men and women. Intersectionality theory provides an analytic framework for interpreting our results. Utilizing a nationwide sample of the Ukrainian population (N = 1908), we found that low socioeconomic status (SES) women rate their health worse than men generally and any other socioeconomic group. Yet women also face the greatest barriers to health care until older ages when the ailments of men cause them to likewise face the obstacles. In reviewing the barrier to health care scale, one barrier—that of health care services being too expensive—dominated the responses with some 52.5 percent of the sample reporting it. Consequently, the greatest problem in Ukraine with respect to health reform reported by the population is the out-of-pocket costs for care in a system that is officially free. These costs, constituting some 40 percent of all national health expenditures, affect women and the aged the most.     

Homegrown Violent Extremism in Trinidad and Tobago: Local Patterns,Global Trends

The article examines the subject of homegrown violent extremism related to militant Islamism in the dual-Island Caribbean state of Trinidad and Tobago (T & T). It employs original research drawn from a series of semi-structured interviews and focus groups conducted between November 2015 and January 2016. Tracing the evolution of endogenous forms of radicalism and extremism the article considers how globalized-exogenous forms of militant Islamism associated with Al Qaeda and its offshoots, such as the so-called Islamic State, have impacted local patterns of violent extremism. The case study draws attention to a state and a region that have received scant attention in terrorism studies. As demonstrated by the article, this oversight is imprudent. There are a number of noteworthy findings from this case study for terrorism studies scholars: the unique historical legacy of radicalism, extremism and insurrection among T & T's Islamists; the country's markedly high levels of extremist travelers on a per capita basis and the high rate of religious converts among those travelers; the inter-linkages between criminality and political violence; and the potential threat posed by Trinidadian and Tobagonian militancy regionally.     

Seal the Deal: Bargaining Positions,Institutional Design,and the Duration of Preferential Trade Negotiations

Multilateral negotiations at the World Trade Organization have stalled. This has contributed to a steep rise in preferential trade agreements (PTAs). At the same time, negotiations for PTAs have not always proven quick and painless: While some treaties are sealed within a few months or days only, other agreements are preceded by protracted bargaining processes in trade and trade-related issue areas. In this article, we provide a theoretical explanation for this empirical variation. More specifically, we argue that PTA negotiations take longer the greater the distance between the prospective partners’ initial bargaining positions. Moreover, we contend that negotiation processes become more protracted the higher the relative ambition of the prospective PTA. Due to the limited links to the domestic political arena in autocracies, we expect this latter effect to play out for groups of democratic bargaining partners only. We test these two hypotheses for 198 preferential trade negotiations using novel measures for bargaining templates and the ambition of PTA clauses. In our two-stage survival models, we find support for our argument. In line with qualitative evidence from recent preferential trade initiatives, our models indicate that services, investment and intellectual property rights are particularly sticky agenda items for democratic leaders at the international bargaining table.     

INSTITUTIONAL LAYERING IN GOVERNING HEALTHCARE QUALITY

Since the 1980s, regulated markets and New Public Management have been introduced in the public sector across the world. How they have affected existing governance mechanisms such as self‐regulation and state regulation has remained largely unexplored, however. This article examines the origins and consequences of institutional layering in governing healthcare quality. Dutch health care, where a market‐based system has been introduced, is used as a case study. The results show that this market‐based system did not replace but modified existing institutional arrangements. As a result, hospitals have to deal with the fragmentation of quality demands. Using the concept of institutional layering, this study shows how different arrangements interact. As a consequence, the introduction of a certain policy reform will work out differently in different countries and policy sectors. Our ‘archaeological’ study in this layering can be seen as an example of how such incremental change can be studied in detail.     

Is Russia a militocracy? Conceptual issues and extant findings regarding elite militarization

The dominant paradigm for understanding contemporary Russia holds that Vladimir Putin's tenure in office has been accompanied by a massive influx of former KGB and military personnel – so-called “siloviki” – into positions of power and authority throughout the polity and economy. Claims of extensive elite militarization, however, are largely based on the analyses of only one research program and, moreover, the validity of the estimates produced by that research program is open to question on numerous grounds. In this article, we review existing research on elite militarization in Russia; discuss a series of conceptual and empirical issues that need to be resolved if valid and meaningful estimation of military–security representation is to be achieved; introduce new findings; and evaluate the totality of existing evidence regarding whether the Russian state under Putin deserves to be labeled a militocracy. We find that the most straightforward reading of existing data indicates that the percentage of siloviki in the political elite during Putin's first two terms as president was approximately half of that which has been widely reported in both scholarship and the media, and also declined during the Medvedev presidency. In addition, our analysis of a broader cross section of the elite estimates military–security representation during the Putin presidency to have been lower still. Overall, existing data paint a less alarming picture of the depths to which siloviki have penetrated the corridors of power since 2000 than has been commonly portrayed and thereby cast doubt on Russia's status as an “FSB state.” On the other hand, past trends also provide some basis for expecting that the numbers of siloviki will once again rise during Putin's current presidential term.     

Adolescent Co-occurring Disorders Treatment: Clinicians' Attitudes,Values, and Knowledge

This study examined community-based clinicians’ (N = 294) attitudes, background/experiences, values, and knowledge relating to issues of co-occurring disorders, which occur at a high rate among adolescents involved in the juvenile justice system. Study results reveal that clinicians self-rate their clinical values and attitudes at or above the expected level of competency, but they concede that their skill and knowledge levels are not adequate. Comparison measures reveal that employment setting conditions, geographic region, hours worked per week, and strongly held convictions about the importance of integrated mental health and substance use disorders service delivery distinguish clinicians’ co-occurring disorders knowledge levels. Implications are offered.