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.     

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.     

Partial order scalogram analysis with base coordinates (POSAC): Its application to crime patterns in all the states in the United States

In this paper, a new nonmetric method called POSAC is presented and illustrated through an analysis of the crime patterns of all the states in the United States. POSAC is a graphical technique for the display of multivariate data in a two-dimensional space. It maps the rows (e.g., states) of a matrix in a way that maximizes the preservation of theirpartial order, with similar states located in close proximity on the map. POSAC is based on the partial order among observations rather than their actual magnitude. POSAC seems to bear the same relationship to the principal-component analysis (PCA) as that borne by the median to the arithmetic mean. As a matter of fact, POSAC is a form of ordinal factor analysis. Its advantage over PCA is its robustness to the data. The technique enables observations and variables to be studied simultaneously. Seven index crime categories are analyzed. In order to demonstrate the utility of POSAC in detecting changes in crime patterns over time, we included in our analysis three selected years: 1944, 1965, and 1987. The results for the year 1987 are compared to those obtained by PCA.     

Do legal variables predict police decisions regarding the prosecution of juvenile offenders?

This study investigated whether legal variables predict police dispositions as regards the prosecution of juveniles. For this purpose first apprehensions of a sample of 479 Israeli adolescents (aged 13.5–15.5) in a one-year period were analyzed. The association between the legal variables and police dispositions was analyzed separately within four hierarchical stages of involvement with the juvenile justice system. Previous referral to court and previous court appearance were found to be excellent predictors of police decision to prosecute. However, in the earlier stages of involvement with the juvenile justice system, (i.e., when juveniles had no previous court referrals or appearances), the predicting power of the few available legal variables (type and seriousness of offense and number of previous police apprehensions) was found to be negligible. In the discussion of the findings, the contradicting labeling and deterrence theories are applied to the functioning of the juvenile units within the police: The present study has empirically identified the specific point where police decision-making reflects a switch-over from the labeling to the deterrence approach. Some suggestions for future research are put forward in order to improve the predictability of police dispositions at the early stages of the juvenile's involvement with the criminal justice system.     

Protection and Dignity in Johannesburg: Shortcomings of South Africa's Urban Refugee Policy

Since the end of apartheid, South African cities have becomedestinations for refugees and asylum seekers from across Africa.In line with its constitutional commitments to human rightsand dignity, South Africa has enacted a refugee policy intendedto maximize freedom and protection by promoting refugees' temporaryintegration into local communities. In doing so, the law guaranteesfreedom of movement, access to many social services, and rightsto compete in labour and housing markets. This article arguesthat because refugees and asylum seekers are effectively unableto convert these legal entitlements into effective protection,South Africa has failed to meet its domestic and internationalobligations. This argument draws particular attention to institutionalfailures in determining refugee status and issuing recognizableidentity documents; denial of essential social services; andabuse at the hands of law enforcement agents. It concludes bysuggesting a positive obligation for the state to counter thefull range of obstacles that prevent asylum seekers and refugeesfrom securing effective protection.