Attorney as Accompagnateur: Resilient Lawyering When Victory is Uncertain or Nearly Impossible

This article comprises a set of essays that explore the public interest lawyer’s capacity to persevere in the face of legal loss that is so regular that pessimism, indifference, and exhaustion set in. The article views the lawyer in the role of accompagnateur. A foundational professional value is to accompany clients—stand beside, stand up for, and give respect and voice to the client’s story—irrespective of victory. In so doing, the lawyer’s deepest source of professional identity and purpose is in accompanying the client well. The thesis is that accompaniment, done well, makes one a better lawyer for her client and simultaneously nourishes the lawyer enough to withstand inevitable losses. This collection of writings from students, a veteran public interest lawyer, and practice faculty traces the arc of a career

Attorney as Accompagnateur: Resilient Lawyering When Victory Is Uncertain or Nearly Impossible,

Social justice lawyers come to the profession intending to make a difference through the instruments of law. And gloriously, they often make a difference in people’s lives for the better. They make our world a more just, compassionate, and tolerant place. But there is no denying that, in poverty law practice, legal success can be elusive, ephemeral, or perhaps a mirage. How does that lawyer feel when the legal remedies at her disposal, even if “successful,” fail to mitigate the injustices suffered by her clients? Are there definitions of professional satisfaction and success that are enduring, even if legal success or social justice is not attainable?This article comprises a set of essays that explore the lawyer’s capacity to persevere in the face of legal loss that is so regular that pessimism, indifference, and exhaustion set in. Our quest is to describe the contours of a lawyer’s role that gives the poverty lawyer professional identity and purpose, despite repeated loss. That role is the accompagnateur.Paul Farmer, a physician and public health activist, coined the terms accompaniment and accompagnateur. In a 2011 commencement address at the Kennedy School of Government at Harvard University,Farmer articulated the role of accompagnateur for health relief workers:To accompany someone is to go somewhere with him or her, to break bread together, to be present on a journey with a beginning and an end. ... [W]e’re not sure exactly where the beginning might be, and we’re almost never sure about the end. There’s an element of mystery, of openness, in accompaniment: I’ll go with you and support you on your journey wherever it leads. I’ll keep you company and share your fate for a while. And by “a while,” I don’t mean a little while. Accompaniment is much more often about sticking with a task until it’s deemed completed by the person or people being accompanied, rather than by the accompagnateurs.Farmer’s vision has resonance with lawyers in social justice and personal strife practices. The authors draw on that inspiration, but adapt it to legal services

Spin content of constituent quarks and one-spin asymmetries in inclusive processes

We consider mechanism for one-spin asymmetries observed in inclusive hadron production. The main role belongs to the orbital angular momentum of the quark-antiquark cloud in the internal structure of constituent quarks. We argue that the origin of the asymmetries in pion production is a result of retaining of this internal angular orbital momentum by the perturbative phase of QCD under transition from the non-perturbative phase. The non-perturbative hadron structure is based on the results of chiral quark models. PACS number(s): 11.30.Qc, 12.40.Pp, 13.75.Ni, 13.88.+eComment: 21 pages LaTeX + 8 figures (not included

Acoustic Bubble Removal to Enhance SWL Efficacy at High Shock Rate: An In Vitro Study

Rate-dependent efficacy has been extensively documented in shock wave lithotripsy (SWL) stone comminution, with shock waves (SWs) delivered at a low rate producing more efficient fragmentation in comparison to those delivered at high rates. Cavitation is postulated to be the primary source underlying this rate phenomenon. Residual bubble nuclei that persist along the axis of SW propagation can drastically attenuate the waveform's negative phase, decreasing the energy which is ultimately delivered to the stone and compromising comminution. The effect is more pronounced at high rates, as residual nuclei have less time to passively dissolve between successive shocks. In this study, we investigate a means of actively removing such nuclei from the field using a low-amplitude acoustic pulse designed to stimulate their aggregation and subsequent coalescence. To test the efficacy of this bubble removal scheme, model kidney stones were treated in vitro using a research electrohydraulic lithotripter. SWL was applied at rates of 120, 60, or 30?SW/min with or without the incorporation of bubble removal pulses. Optical images displaying the extent of cavitation in the vicinity of the stone were also collected for each treatment. Results show that bubble removal pulses drastically enhance the efficacy of stone comminution at the higher rates tested (120 and 60?SW/min), while optical images show a corresponding reduction in bubble excitation along the SW axis when bubble removal pulses are incorporated. At the lower rate of 30?SW/min, no difference in stone comminution or bubble excitation was detected with the addition of bubble removal pulses, suggesting that remnant nuclei had sufficient time for more complete dissolution. These results corroborate previous work regarding the role of cavitation in rate-dependent SWL efficacy, and suggest that the effect can be mitigated via appropriate control of the cavitation environment surrounding the stone.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140375/1/end.2013.0313.pd

Search for Direct CP Violation in Non-Leptonic Decays of Charged Ξ\Xi and Λ\Lambda Hyperons

A search for direct CP violation in the non-leptonic decays of hyperons has been performed. In comparing the product of the decay parameters, $\alpha_{\Xi}\alpha_{\Lambda}$, in terms of an asymmetry parameter, $A_{\Xi\Lambda}$, between hyperons and anti-hyperons in the charged $\Xi \to \Lambda \pi$ and $\Lambda \to p \pi$ decay sequence, we found no evidence of direct CP violations. The parameter $A_{\Xi\Lambda}$ was measured to be $0.012 \pm 0.014$.Comment: Submitted for publication; RevTex, 13 pages, 4 figure

Enhanced High-Rate Shockwave Lithotripsy Stone Comminution in an In Vivo Porcine Model Using Acoustic Bubble Coalescence

Cavitation plays a significant role in the efficacy of stone comminution during shockwave lithotripsy (SWL). Although cavitation on the surface of urinary stones helps to improve fragmentation, cavitation bubbles along the propagation path may shield or block subsequent shockwaves (SWs) and potentially induce collateral tissue damage. Previous in vitro work has shown that applying low-amplitude acoustic waves after each SW can force bubbles to consolidate and enhance SWL efficacy. In this study, the feasibility of applying acoustic bubble coalescence (ABC) in vivo was tested. Model stones were percutaneously implanted and treated with 2500 lithotripsy SWs at 120 SW/minute with or without ABC. Comparing the results of stone comminution, a significant improvement was observed in the stone fragmentation process when ABC was used. Without ABC, only 25% of the mass of the stone was fragmented to particles <2?mm in size. With ABC, 75% of the mass was fragmented to particles <2?mm in size. These results suggest that ABC can reduce the shielding effect of residual bubble nuclei, resulting in a more efficient SWL treatment.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140087/1/end.2016.0407.pd

Histotripsy Erosion of Model Urinary Calculi

Background and Purpose: Histotripsy is a pulsed focused ultrasound technology in which initiation and control of acoustic cavitation allow for precise mechanical fractionation of tissues. The present study examines the feasibility of using histotripsy for erosion of urinary calculi. Materials and Methods: Histotripsy treatment was delivered from a 750-kHz transducer in the form of 5-cycle acoustic pulses at a 1-kHz pulse repetition frequency. Model stones were sonicated for 5 minutes at peak negative pressures (p-) of 10, 15, 19, 22, and 24-MPa. Resulting fragment sizes and comminution rates were assessed and compared with those achieved with a piezoelectric lithotripter (Wolf Piezolith 3000) operated at 2-Hz pulse repetition frequency and power level 17 (p- = 14-MPa). Results: Histotripsy eroded the surface of stones producing fine (<100--m) particulate debris in contrast to the progressive and incomplete subdivision of stones achieved with piezoelectric lithotripsy. The histotripsy erosion rate increased with increasing peak negative pressure from 10 to 19-MPa and then saturated, yielding an average rate of 87.9+/-12.8 mg/min at maximum treatment intensity. Piezoelectric lithotripsy achieved an average treatment rate of 110.7+/-27.4 mg/min. Conclusions: Histotripsy comminution of urinary calculi is a surface erosion phenomenon that is mechanistically distinct from conventional shockwave lithotripsy (SWL), producing only fine debris as opposed to coarse fragments. These characteristics suggest that histotripsy offers a potential adjunct to traditional SWL procedures, and synergistic interplay of the two modalities may lead to possible increases in both rate and degree of stone fragmentation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90440/1/end-2E2010-2E0407.pd

Human Capital Policies: What They Can and Cannot Do for Productivity and Poverty Reduction in Latin America

Raising labor productivity is recognized as a critical factor for increasing economic growth and reducing poverty levels in Latin America. Low levels of education continue to be singled out as the main obstacle to higher productivity in the region. We examine the scope for education to lift labor incomes above poverty levels in Latin America and find that in many countries education, by itself, has a positive, but limited, potential to increase wages above a minimum level. In general, the prospects are dim because progress in raising average schooling levels has been slow even under the best historical scenarios. We also examine whether the apparent failure of education can be explained by low wage returns to schooling, and poor underlying conditions. We find that investments in education continue to have important payoffs but poor underlying conditions explain the modest prospect for the role of education in the short run. This leads us to consider what additional policies should be pursued in order to ensure higher productivity for workers in the region

The Feasibility of Utilizing the Open Dynamic Interaction Network (ODIN) app to assess rEMA data across 30 days among those Recovering from Alcoholism

About ~4 million people with an alcohol use disorder receive treatment annually, and frequent relapse has produced a rapid revolving door between recovery and use. This paper presents preliminary data from a prospective micro-longitudinal study (30 days) that examines co-evolution of relapse risk processes of people with alcohol use disorders who entered a short-term residential substance use treatment. The primary goal of the current data was to assess the feasibility of using the open dynamic interaction network (ODIN) responsive ecological momentary assessment (rEMA). rEMA collected daily estimates on affect, urges, sober-support engagement, and use. The ODIN app administered twelve questions at established EMA times each day. GPS identified engagement in sober support activities and alcohol cue exposure (e.g., gas stations, grocery stores, bars) prompted additional questions. Of the eight hundred questions asked over 31 days, the mode for questions answered was 500. Five-day estimates showed that 80% of the participants answered between 80-100 questions (10-30 questions/day). Also, the ODIN app acquired 95% of GPS readings across 30 days (~288 GPS readings/day). Most were satisfied with stability (84%), look/feel (82.4%), and ease of use (92.2%) of the ODIN app. Participants also reported interest in longer assessments (100%) using the app if it prompted them to call sponsor (85%) or to use relapse prevention skills (72%). Preliminary findings show that the ODIN platform accurately and efficiently collects data amongst this population. There was a high rate of acceptability, satisfaction, and interest in using ODIN to help them engage in sober support/relapse prevention