Regionalism and the WTO: Opportunities and dangers for Africa

An examination of regionalism and its ramifications for the African region within the framework of the World Trade Organization and other economic partnership agreements being negotiated with this and other regions.     

Towards a Guide for Constructing and Disseminating Counternarratives to Reduce Support for Terrorism

Despite widespread recognition that the use of counternarratives is an important strategic component of countering violent extremism, to date, there are no comprehensive guidelines on how to develop and distribute counternarratives to effectively reduce support for terrorism. To redress this, we offer communication and psychology theory-based procedures for (1) analyzing terrorist narratives, (2) constructing counternarratives that challenge terrorist narratives, and (3) disseminating the counternarratives to overcome barriers to persuasion. Analysts and practitioners can use such guidelines in developing counternarratives to reduce support for violent extremism.     

Postmortem Computed Tomography in Firearm Homicides: A Retrospective Case Series,

Postmortem computed tomography (PMCT) is integrated into the evaluation of decedents in several American medical examiner offices and medicolegal death investigative centers in many other countries. We retrospectively investigated the value of PMCT in a series of firearm homicide cases from a statewide centralized medical examiner’s office that occurred during 2016. Autopsies were performed or supervised by board-certified forensic pathologists who reviewed the PMCT scans prior to autopsy. PMCT scans were re-evaluated by a forensic radiologist blinded to the autopsy findings and scored by body region (head–neck, thoracoabdominal, and extremities). Injury discrepancies were scored using a modified Goldman classification and analyzed with McNemar’s test. We included 60 males and 20 females (median age 31 years, range 3–73). Based on PMCT, 56 (79.1%) cases had injuries relevant to the cause of death in a single body region (24 head–neck region, 32 thoracoabdominal region). Out of these 56 cases, 9 had a missed major diagnosis by PMCT outside that region, including 6 extremity injuries visible during standard external examination. Yet all had evident lethal firearm injury. We showed that PMCT identifies major firearm injuries in homicide victims and excludes injuries related to the cause of death in other regions when a single body region is injured. Although PMCT has a known limited sensitivity for soft tissue and vascular pathology, it can be combined with external examination to potentially reduce or focus dissections in some of these cases depending on the circumstances and medicolegal needs.     

Evaluating the Potential for Unintentional Occupational Exposure to Fentanyl and Fentanyl Analogues Among Medicolegal Death Investigators and Autopsy Technicians

Recent increases in deaths in the United States from synthetic opioids such as fentanyl and fentanyl analogues (fentanyls) have raised concerns about possible occupational exposures to these potent agents. Medicolegal death investigators and autopsy suite staff might perform job tasks involving exposure to fentanyls. The potential for exposure to fentanyls among medicolegal death investigators and autopsy technicians at a state medical examiner's office was evaluated through review of caseload characteristics, injury and illness logs, and procedures and policies and discussions with management and employee representatives. The evaluation showed that this medical examiner's office had low potential for work-related exposure to fentanyls; its standard operating procedures and personal protective equipment requirements should reduce the potential for occupational exposure. Medicolegal death investigation agencies can develop and implement guidance to control exposures and provide workforce education and training to reduce the potential for work-related exposure to fentanyls.     

Risk assessment and suicide prevention in primary care

General practitioners (GPs) are assumed to occupy an important position in the prevention of suicide through the introduction of risk assessment techniques commonly used in psychiatric practice. Despite this theoretical role for primary care services, it remains unclear how frequently GPs implement risk assessment in patients who may be vulnerable to suicide. To address this, a retrospective survey of probable suicides was conducted within a primary care setting utilizing a questionnaire of GPs who had experienced a patient suicide and was augmented by hospital and coroners' records. 85% of questionnaires were returned and 61 deaths were adjudged as suicides during the year long census period. 75% of suicides were male and 54% were aged under 35.28% were in contact with psychiatric services prior to death, although 60% had some diagnosis of mental disorder. GPs had little knowledge of a patient's life circumstances in up to half of cases. Recording of risk assessment occurred in 38% of subjects, was positively associated with prior psychiatric contact (p = 0.001) but negatively associated with presence of physical illness (p = 0.004), older patient age (p = 0.04), and GPs length in practice (p = 0.05). One GP felt their suicide case was preventable. The low rate of risk assessment and limited knowledge of patient lifestyle point to the need for active engagement of GPs in future suicide prevention strategies and should influence the content of training programs in primary care.     

Knowledge and attitudes about AIDS: A comparison of public high school students,incarcerated delinquents,and emotionally disturbed adolescents

This study compared AIDS knowledge and attitudes in public high school students (N=167), incarcerated delinquents (N=166), and emotionally disturbed (SED) adolescents (N=151). The response measure was a 50-item Acquired Immunodeficiency Syndrome (AIDS) questionnaire that was previously used by Bell et al., in their 1991 study of learning disabled adolescents. Although AIDS knowledge was moderately high in all three groups, widespread misunderstandings about disease transmission and awareness of high-risk groups and practices were noted. Knowledge scores were significantly higher in the public school sample than in the SED adolescents; moreover, they tended to be slightly higher (p<0.10) than the delinquent group as well. Teenagers with the severest emotional problems were by far the least informed. Age and race were also predictive of AIDS knowledge. Other results showed that delinquents were more permissive in their attitudes about sex, more inclined to disdain safe sex practices, and more likely to feel threatened by high-risk groups as well as powerless to protect themselves against AIDS. Generally speaking, the findings extend the work of other investigators on the needs for AIDS education in adolescents. The need is especially urgent in delinquent and emotionally disturbed youth who may require a more comprehensive intervention because of their greater knowledge deficits, propensity for high-risk practices, and tendency to deny or underestimate their own vulnerability.Received Ph.D. in clinical psychology from the University of Utah in Salt Lake City. Research interests include health behavior change and the treatment of anxiety and habit disorders. To whom correspondence should be addressed.Received M.A. degree in psychology from the University of the Pacific. Research interests include health behavior change and medical epidemiology.Received Ph.D. in psychology from the University of Auckland, Auckland, New Zealand. Research interests are in child and adolescent psychiatry and the delivery of mental health services.Received Ph.D. in biostatistics from the Medical College of Virginia. Research interests are in general linear models.     

Budgeting Rights: The Case of Jail Litigation

Judicial decisions are one element in the erosion of local government budgetary discretion. For example, litigation concerning constitutional rights forces local government officials to allocate resources toward the rights-based population. While rights-based allocation decisions may narrow the budgetary discretion of public officials, some managers may, paradoxically, be "better-off"—defined as the ability to protect and defend their budgets — when discretion is reduced. This thesis is tested through a case study of jail overcrowding litigation in a county government.