The many faces of access: reasons for medically nonurgent emergency department visits

Investigating why people use the hospital emergency department (ED) for visits considered medically nonurgent can enhance our understanding of people's expectations of health care services, of their conceptions of prudent lay judgment, and of difficulties in negotiating the logistics of primary care services. This study identified reasons for such ED use from users' perspectives in both pediatric and adult visits. Respondents were asked to explain what brought them to the ED and to define an emergency. The study was conducted in two northeastern U.S. hospital EDs. The analysis drew on a convenience sample of 408 (331 pediatric, 77 adult users) face-to-face interviews that employed both open- and closed-ended questions. Findings indicate most patients had medical insurance and a regular place of care and most arrived by car or taxi. Twelve main themes emerged under three main categories: conceptions of needs, appropriateness, and preference for the ED. The findings indicate that various reasons for ED use may be construed as access issues. These include beliefs regarding limited availability of after-hour consultation services and of timely appointments at one's primary care site. Drawing on the findings, a typology that distinguishes between groups of users according to their preference for the ED, a level of congruence between their own reason and their definition of an emergency was developed. The typology suggests that people's concerns that influence their decision to come to the ED cannot be solved simply by expanding primary care services or by educational interventions. Its application yields recommendations for services and interventions.     

SAYYID QUTB'S INFLUENCE ON THE 11 SEPTEMBER ATTACKS

The 11 September attacks cannot be understood fully without an understanding of the ideas of Sayyid Qutb, who is widely acknowledged as the intellectual godfather for the various modern radical Islamic movements, including Al-Qaeda. Qutb's writings are important because they define the core elements that have been adopted by all radical Islamic movements. These include: (1) an extreme hostility toward Western culture, especially the role of women and sexual mores in the West; (2) the formation of society under the rule of Sharia, Islamic law; (3) the overthrow of governments not under the rule of Sharia by means of holy war; and (4) an intense hatred of Jews and distrust of Christians. This article also illustrates Qutb's influence on radical Islamic groups.     

The other resource curse: extractives as development panacea

Since 2010, many African governments have challenged twenty years of extractive sector liberalization that has played a key role in unlocking mineral riches and attracting foreign direct investment. The potential for extractives to drive economic structural transformation is intuitively attractive, the Africa Mining Vision (2009) document providing a primary template. Geological inheritance alone, however, is not a panacea for economic development, industrialization or poverty alleviation. While much attention to the ‘resource curse’ has identified the problem of excessive rent-seeking and the consequent impact on elite consolidation, democracy, governance and macroeconomic distortions, a more fundamental problem, the ‘other resource curse’, may be an overlooked driver: a lingering assumption that mineral resources should straightforwardly provide significant revenue streams for public goods, inputs for industrial transformation, and extensive employment. Geology alone is neither conducive nor antithetical to economic development. Stakeholders require a more comprehensive understanding of the possibilities and limits of extractives in contemporary Africa.     

Is ‘Chloe liked Olivia’ a lesbian plot?

Despite Virginia Woolf's lesbian vision of love and friendship between Chloe and Olivia in A Room of One's Own, the literary and critical text often serves to shut lesbians into a closet of prose. Among the debilitating myths used by writers are the ‘Phaon myth’ (that authentic lesbian experience must be terminated by an inauthentic heterosexual rescue), the vampire myth, and the myth of masculinity. The latter in particular has served to divide heterosexual women from their lesbian sisters, so that much feminist literary criticism displays a pervasive heterosexual bias by ignoring or distorting lesbian texts and subtexts. This paper suggests ways in which the word and concept ‘lesbian’ is being reclaimed by lesbian writers and critics. It calls for all women to destroy patriarchal myths about lesbians; reread literary texts for their lesbian subtexts; recover the works of lesbians, particularly lesbians of color; and, finally, proclaim the word ‘lesbian’ forcefully despite the threats posed by a misogynistic academy and society.     

A comparison of different delinquency measures derived from self-report data

The purpose of this research was to explore different ways of using self-report data to derive measures of juvenile delinquent behavior. The subjects were 161 public school children in the Omaha area, and 1,030 public school children and 665 adjudicated delinquents in the metropolitan areas of Baltimore, Indianapolis, and Phoenix. The Omaha youths responded to twenty-eight self-report items two times with an intervening period of three weeks and then rated the items for seriousness. Four measures of delinquency were derived from the data: frequency of activity, diversity of activity, seriousness of activity, and progression into delinquent behavior. The four measures were shown to be highly reliable and strongly intercorrelated; none was shown to be consistently better than the other three. Rated seriousness and reported frequency of behavior were highly negatively correlated, giving support to the use of frequency measures in building delinquency scales. All four scales showed differences within the Omaha sample as a function of sex, age, and birth order; but the differences were not always in the same directions when the four measures were used.     

Thoughtfully Reflective Decision Making and the Accumulation of Capital: Bringing Choice Back In

In this paper we relate a particular type of decision making, thoughtfully reflective decision making (TRDM) in adolescence, to successful and unsuccessful life outcomes in young adulthood. Those who are thoughtfully reflective in their decision making are more likely to consider possible alternative routes to goal attainment, weigh the costs and benefits of those alternatives, and critically revisit the decision once made to examine what went well and what went wrong. We also argue that what mediates the effect of TRDM on later life outcomes is the accumulation of capital. Those who use better decision making practices are more likely to recognize the resources provided by and make the necessary investments to accumulate human, social and cultural capital. These notions are theoretically linked to conceptions of criminal offenders as both rational planners and decision makers and as fully human agents. Using data from the Add Health data set, our hypotheses are largely confirmed. Those who are higher in TRDM as adolescents were more likely to have enrolled in or graduated from college, to be in better physical health, are more involved in civic and community affairs, less likely to commit criminal acts, use illegal drugs and be involved in heavy drinking as adults. TRDM is also positively related to the accumulation of human, social and cultural capital. Finally, a substantial part of the effect of TRDM on young adult outcomes was mediated by capital accumulation. The implications of these findings for future theory and research are discussed.     

The Centrality of Theory in Modern Day Crime Prevention: Developments,Challenges, and Opportunities

Theory matters in crime prevention. Indeed, but this is hardly the full story. Crime prevention is oftentimes viewed as atheoretical—not grounded in the etiology of crime and offending. Reasons abound for this view, and the recent interest in an evidence-based approach to policy-making has been at the forefront. This article reviews the role that theory plays in modern day crime prevention, with a special focus on the three main crime prevention strategies: developmental, community, and situational. The review identifies a number of key challenges and opportunities for making theory more central to crime prevention. It suggests that the classification system employed in situational crime prevention has allowed for a more explicit connection between sound theory and prevention techniques, and may provide important lessons for developmental and community crime prevention.     

Pedagogy of the Logic Model: Teaching Undergraduates to Work Together to Change Their Communities

Undergraduate community psychology courses can empower students to address challenging problems in their local communities. Creating a logic model is an experiential way to learn course concepts by “doing.” Throughout the semester, students work with peers to define a problem, develop an intervention, and plan an evaluation focused on an issue of concern to them. This report provides an overview of how to organize a community psychology course around the creation of a logic model in order for students to develop this applied skill. Two undergraduate student authors report on their experience with the logic model assignment, describing the community problem they chose to address, what they learned from the assignment, what they found challenging, and what they are doing now in their communities based on what they learned.