Coming to America: An Examination of the U.S. Immigration Debate in its Historical Context

The United States is considered a country of immigrants, but a historical tension has existed between new arrivals and the “native” population. Policies regarding immigration have frequently mirrored the nativist fervor that is created in opposition to large influxes of immigrants. The debate about revamping immigration policy, that has been a key issue in Congress in 2006, is not surprising in an historical context. The concern about large numbers, the fear of draining social services, dilution of American culture, loss of American jobs, and the compromising of national security are all concerns that have been voiced recently, and are almost identical to the concerns of earlier generations of Americans regarding previous influxes of immigrants. This essay explores the historical context in which the new debate is set and uses this history to deconstruct the anti-immigration arguments. Finally, the essay proposes, using humanitarian concern and historical roots as a guide, ways in which United States’ policy can be improved concerning immigration

Manual-assisted cognitive therapy for self-harm in personality disorder and substance misuse: a feasibility trial

<b>Aims and method</b> To assess the feasibility of conducting a larger, definitive randomised controlled trial of manual-assisted cognitive therapy (MACT), a brief focused therapy to address self-harm and promote engagement in services. We established recruitment, randomisation and assessment of outcome within a sample of these complex patients admitted to a general hospital following self-harm. We assessed symptoms of depressed mood, anxiety and suicidality at baseline and at 3 months’ follow-up.<p></p> <b>Results</b> Twenty patients were randomised to the trial following an index episode of self-harm, and those allocated to MACT demonstrated improvement in anxiety, depression and suicidal ideation.<p></p> <b>Clinical implications</b> It is feasible to recruit a sample of these complex patients to a randomised controlled trial of MACT following an index episode of self-harm. There is preliminary support that MACT could be an acceptable and effective intervention in patients with personality disorder and substance misuse

Interprofessional Education Enhancement: Inclusion of Occupational Therapy

The increase in interprofessional education (IPE) opportunities provides an excellent opportunity for occupational therapy (OT) educators to partner with other health professions to deepen the understanding of how the OT profession adds value to future healthcare teams. The purpose of this study was to describe the development and impact of a curricular unit about the OT profession that was integrated into an established IPE program for medical, advanced practice nursing, pharmacy and social work students. A Needs Assessment was conducted by embedding an OT consultant within interprofessional student teams working in clinical environments over six weeks to observe baseline understanding of how student primary care teams work with OT professionals. From these observations, a curricular unit was designed that included lecture, interactive work stations, and case studies. Students completed pre and post surveys in order to assess their learning. Quantitative and qualitative analysis of pre and post surveys indicated a significant increase in knowledge, application of information, and confidence to refer to and utilize OT in clinical practice. Interprofessional students learned about OT scope of practice, possible interventions, and examples of appropriate referrals. The curricular unit provided an excellent example of how OT professionals can partner with health professions schools to provide content about OT when OT students are not accessible. Future improvements include assessment of longitudinal impact of the curriculum on health professions behavior, including impact on patient referrals to OT by primary care teams

A Multi-Factorial Risk Prioritization Framework for Food-Borne Pathogens

To lower the incidence of human food-borne disease, experts and stakeholders have urged the development of a science- and risk-based management system in which food-borne hazards are analyzed and prioritized. A literature review shows that most approaches to risk prioritization developed to date are based on measures of health outcomes and do not systematically account for other factors that may be important to decision making. The Multi-Factorial Risk Prioritization Framework developed here considers four factors that may be important to risk managers: public health, consumer risk perceptions and acceptance, market-level impacts, and social sensitivity. The framework is based on the systematic organization and analysis of data on these multiple factors. The basic building block of the information structure is a three-dimensional cube based on pathogen-food-factor relationships. Each cell of the cube has an information card associated with it and data from the cube can be aggregated along different dimensions. The framework is operationalized in three stages, with each stage adding another dimension to decision-making capacity. The first stage is the information cards themselves that provide systematic information that is not pre-processed or aggregated across factors. The second stage maps the information on the various information cards into cobweb diagrams that create a graphical profile of, for example, a food-pathogen combination with respect to each of the four risk prioritization factors. The third stage is formal multi-criteria decision analysis in which decision makers place explicit values on different criteria in order to develop risk priorities. The process outlined above produces a ‘List A’ of priority food-pathogen combinations according to some aggregate of the four risk prioritization factors. This list is further vetted to produce ‘List B’, which brings in feasibility analysis by ranking those combinations where practical actions that have a significant impact are feasible. Food-pathogen combinations where not enough is known to identify any or few feasible interventions are included in ‘List C’. ‘List C’ highlights areas with significant uncertainty where further research may be needed to enhance the precision of the risk prioritization process. The separation of feasibility and uncertainty issues through the use of ‘Lists A, B, and C’ allows risk managers to focus separately on distinct dimensions of the overall prioritization. The Multi-Factorial Risk Prioritization Framework provides a flexible instrument that compares and contrasts risks along four dimensions. Use of the framework is an iterative process. It can be used to establish priorities across pathogens for a particular food, across foods for a particular pathogen and/or across specific food-pathogen combinations. This report provides a comprehensive conceptual paper that forms the basis for a wider process of consultation and for case studies applying the framework.risk analysis, risk prioritization, food-borne pathogens, benefits and costs

The cis-regulatory system of the tbrain gene: Alternative use of multiple modules to promote skeletogenic expression in the sea urchin embryo

The genomic cis-regulatory systems controlling regulatory gene expression usually include multiple modules. The regulatory output of such systems at any given time depends on which module is directing the function of the basal transcription apparatus, and ultimately on the transcription factor inputs into that module. Here we examine regulation of the Strongylocentrotus purpuratus tbrain gene, a required activator of the skeletogenic specification state in the lineage descendant from the embryo micromeres. Alternate cis-regulatory modules were found to convey skeletogenic expression in reporter constructs. To determine their relative developmental functions in context, we made use of recombineered BAC constructs containing a GFP reporter and of derivatives from which specific modules had been deleted. The outputs of the various constructs were observed spatially by GFP fluorescence and quantitatively over time by QPCR. In the context of the complete genomic locus, early skeletogenic expression is controlled by an intron enhancer plus a proximal region containing a HesC site as predicted from network analysis. From ingression onward, however, a dedicated distal module utilizing positive Ets1/2 inputs contributes to definitive expression in the skeletogenic mesenchyme. This module also mediates a newly discovered negative Erg input which excludes non-skeletogenic mesodermal expression

Developing SASSA: a Soil Analysis Support System for Archaeologists

A constant problem for field archaeologists is the need for familiarity with the core concepts of a diverse range of specialist disciplines. Soils and sediments are an integral part of archaeological sites, yet the teaching of soils in archaeology degrees is variable and many archaeologists complain they are lacking in the confidence and skills required to describe and interpret the deposits they excavate. SASSA (Soil Analysis Support System for Archaeologists) is a free-to-use, internet based system designed to familiarise archaeologists with the concepts and possibilities offered by geoarchaeology (the scientific study of soils and sediments). SASSA consists of two core components: the knowledge base and field tool. The ‘front-end’ of the website is the knowledge base; this uses Wiki technology to allow users to add their own content and encourage dialogue between archaeologists and geoarchaeologists. Whilst the field tool uses an XML data structure and decision tree, decision support system to guide the user through the process of describing and interpreting soils and sediments. SASSA is designed for use on both ‘static’ (PC) and ‘mobile’ (PDA and laptop) hardware in order to provide in-situ field support as well as offering office-based ‘reference book style’ help. This article introduces the aims of SASSA, presents SASSA as a user might experience it, and discusses the computing technology used to construct the system