Predictors of Early Engagement in Home Visitation

Predictors of engagement in mothers receiving home visitation in the first year of service was examined. Early engagement was studied in three ways: (1) length of time active in the program during the first year of service (duration), (2) number of visits received (quantity), and (3) gaps in service between visits (consistency). Examined visits received in 515 first-time mothers in a Healthy Families America (HFA) program. Parameters of engagement were investigated, and predictors of engagement were identified using demographics and the Kempe Family Stress Inventory. Inclusive of the Assessment Visit, 31.8% of mothers disengaged prior to the first month of service. Remaining active in the program was associated with being Caucasian, and increased parenting risk (mental health/substance abuse history, low social support, increased stress). Most mothers had fewer home visits than prescribed. Gaps in prescribed service were common, with 89.4% of mothers experiencing gaps between visits of 1 month, and dropping to 16.4% having gaps of 2 months. In contrast to findings from clinic-based interventions, early engagement in home visitation is associated with lower levels of functioning and acute needs. These findings add to a growing body of literature suggesting that increased adversity promotes engagement in prevention programs in general, and home visitation programs in particular. To the extent that mothers who are actively engaged in home visitation are likely to have increased psychosocial needs, curricula may require modification and augmentation to address these needs and optimize program effectiveness.     

FRAGMENTED COURTS AND CHILD PROTECTION CASES

This article discusses the proposed implementation of a model court project that can serve as an alternative approach to adjudicating child abuse and neglect cases. The model project allows criminal child abuse cases to be processed with related civil proceeding in one court before one judge. This integrated approach can ensure more efficient case processing, more informed judicial decision making, and more effective delivery of services to children and families.     

The diagnosis of diffuse axonal injury in routine autopsy practice

A 40-year-old pedestrian was involved in a road traffic accident. He lost consciousness immediately and remained comatose for 6 months until he died of a bronchopneumonia. Examination of the fixed brain revealed the late results of diffuse axonal injury. Not all the features were readily visible macroscopically, but required a limited number of histological sections from readily predictable sites for demonstration. Special stains played only a confirmatory role. This case illustrates some of the problems in diagnosing one of the commoner patterns of brain damage in head injury, and shows how the problem may best be approached in practice.     

Strong life sciences in innovative weak contexts: a “developmental” approach to a tantalizing mismatch

Life sciences are the best developed area of academic research throughout Latin America. Biomedical research has been particularly successful. However, generally speaking, excellence in research has not been accompanied by commercially successful innovations, a pattern that differs from what has happened in many highly industrialized countries, even small ones. The paper explores some causes of such disappointing outcome, stressing in particular the historical lack of political and social legitimacy exhibited by innovation policies in underdevelopment. From a developmental point of view it is of great importance the building of such legitimacy. One way of doing so is to link more tightly innovation policies to social concerns; bio-innovation is suggested as a productive path towards that aim.

Optimization of Human mtDNA Control Region Sequencing for Forensic Applications

Sequencing mitochondrial DNA hypervariable regions I and II (HVI and HVII) is useful in forensic missing person and unidentified remains cases. Improvements in ease and sensitivity of testing will yield results from more samples in a timely fashion. Routinely, amplification of HVI and HVII is followed by Sanger sequencing using the BigDye^® Terminator v3.1 Cycle Sequencing kit (Applied Biosystems) using 4 μL of ready reaction mix (RRM). Each sequencing reaction is then purified through column filtration before capillary electrophoresis. Using lower amounts of RRM (2 μL or 1 μL) and purification using BigDye^® XTerminator^? (Applied Biosystems) instead of columns showed no loss of sequence length and increased the quality and the sensitivity of testing, allowing HVI and HVII typing from mitochondrial genome equivalent to 125 fg of nuclear DNA, or 100 pg of HVI/HVII amplicons. Using this methodology, testing can be completed in 1 day, and the cost of testing is reduced.     

An Empirical Validation Study of Popular Survey Methodologies for Sensitive Questions

When studying sensitive issues, including corruption, prejudice, and sexual behavior, researchers have increasingly relied upon indirect questioning techniques to mitigate such known problems of direct survey questions as underreporting and nonresponse. However, there have been surprisingly few empirical validation studies of these indirect techniques because the information required to verify the resulting estimates is often difficult to access. This article reports findings from the first comprehensive validation study of indirect methods. We estimate whether people voted for an anti‐abortion referendum held during the 2011 Mississippi General Election using direct questioning and three popular indirect methods: list experiment, endorsement experiment, and randomized response. We then validate these estimates against the official election outcome. While direct questioning leads to significant underestimation of sensitive votes against the referendum, indirect survey techniques yield estimates much closer to the actual vote count, with endorsement experiment and randomized response yielding the least bias.