Isolated Voices: Perspectives of Teachers, School Nurses, and Administrators Regarding Implementation of Sexual Health Education Policy.

BackgroundComprehensive sexual health education (SHE) reduces risky sexual behavior and increases protective behavior in adolescents. It is important to understand how professionals responsible for implementing SHE policy interpret state and local policy and what influences their commitment to formal SHE policy implementation.MethodsThis descriptive study explored content and delivery of SHE policy in a rural, southwestern state with high levels of poverty, unintended adolescent pregnancy, and sexually transmitted infections. The social ecological model (SEM) was used to better understand levels of influence on the implementation of SHE policy.ResultsWe conducted telephone surveys with 38 teachers, 63 nurses, and 21 administrators in public secondary schools. There was substantial local variability in the scope and content of SHE curricula. Respondents identified significant barriers to the delivery of SHE content and minimal evaluation of whether educational objectives were met. Based on participant responses, community and organizational SEM levels had the greatest influence on SHE policy implementation, although examples of all SEM levels were identified.ConclusionsGiven perceived challenges regarding subject matter, successful SHE implementation at the local level requires committed stakeholders working in concert at the school and community levels, backed by strong policy commitment at the state level

Breeding Biology of Red-throated Loons in the Canadian Beaufort Sea Region

The breeding biology of the red-throated loon in the Canadian Beaufort Sea region was investigated 1985 to 1989. Five study plots were established with a total area of 276 sq. km and over 200 pairs of loons on territory each breeding season. Loon densities ranged from 0.6 pairs/sq. km on the Yukon coast to 1.8 pairs/sq. km at Toker Point on the Tuktoyaktuk Peninsula. An average of 73% of the pairs on territory nested each year. Productivity averaged 0.63 young/nesting pair. The median date of egg laying ranged from 19 to 24 June in four years, but was 3 July in a year when spring thaw was late. The chicks fledged a mean of 47 d after hatch (n=10), the first clutch chicks leaving the nesting pond in late August to mid-September. In all but one year, the mortality rate was higher for eggs than chicks, with egg losses peaking in the second half of incubation. Most (82%) chick losses occurred within three weeks of hatch (n=61). Just 13% of the ponds were occupied in all five years of the study, while 39% were used in only one year. At two of the study plots, ponds with pairs that successfully reared at least one chick had a greater tendency to be occupied the following year than did ponds with unsuccessful pairs. At the other three plots, reuse of ponds was independent of breeding success the previous year.Key words: red-throated loon (Gavia stellata), breeding biology, Beaufort SeaOn a étudié la reproduction du huart à gorge rousse dans la partie canadienne de la mer de Beaufort de 1985 à 1989. À chacune des périodes de reproduction, on a observé plus de 200 couples de huarts territoriaux répartis dans cinq zones expérimentales couvrant une superficie totale de 276 km². La densité des huarts a varié de 0.6 couple par km² sur la côte du Yukon à 1.8 couple par km² à Toker Point sur la péninsule de Tuktoyaktuk. Le nombre moyen annuel de couples nicheurs territoriaux s'est élevé à 73%. La productivité moyenne a été de 0.63 oisillon par couple nicheur. La date médiane de ponte s'est située du 19 au 24 juin pour quatre des cinq années; l'autre année la date médiane de ponte a été le 3 juillet à cause d'un dégel printanier tardif. Le premier vol des oisillons a eu lieu en moyenne 47 jours après l'éclosion (n = 10), la première couvée quittant l'étang de nidification entre la fin août et la mi-septembre. À l'exception d'une année, le taux de mortalité a toujours été plus élevé dans le cas des oeufs que dans celui des oisillons et a été maximal pendant la deuxième moitié de l'incubation. La mortalité des oisillons a particulièrement été forte (82%) au cours des trois premières semaines suivant l'éclosion (n = 61). Seuls 13% des étangs ont été utilisés pendant les cinq années de l'étude alors que 39% l'ont été pendant seulement une année. Le succès de la reproduction n'a eu un effet sur la réutilisation d'un étang l'année suivante que dans deux des cinq zones expérimentales.Mots clés: huart à gorge rousse (Gavia stellata), reproduction, mer de Beaufor

Chaos and Control: The Hidden Tension between Liberalism and Freedom

From self-sovereignty to individual independence, freedom is about control. When people want freedom, they yearn for exclusive control over their life. Liberal institutions, from democracy to market economies, however, do not offer people control. Instead, liberal machinery outsources control to a collective, invisible power. Far fom control, chaos governs liberal society. In the earliest stages of development, liberalism did serve the pursuit of freedom because liebral reforms focused on the destruction of controlling power from above, i.e. the expansion of liebrty. Because controlling onself first requires being controlled by no one lese, liberty is the first, but incomplete, step toward freedom. After these first stages, however, the relationship breaks down. Liberalism can only liberate; it cannot cultivate the self-power at the heart of freedom. By continuing to promise a freedom liberalism cannot deliver, those who continue to wed liberalism and freedom undermine liberal society and sow the seeds of disaster

Traumatic injury to a wrist with incidental Madelung's deformity

SummaryWe present a longstanding case of subtle Madelung's deformity in association with a new traumatic radial styloid fracture. Magnetic resonance imaging accurately distinguished this deformity from an acute fracture and highlighted the correct cause of the patient's pain. An unnecessary procedure was avoided