Prevalence and Patterns of Injury-Related Mortality in Nevada

Too many lives are lost to injury in the United States and in Nevada. Nearly 200,000 people in our country die each year from injuries, which is equivalent to one death every three minutes (CDC 2017b). Each of these deaths not only extinguishes a life, but also affects the friends, family, and community of the deceased. And deaths from injury are costly: researchers estimate that costs from fatal injuries exceed $200 billion (CDC 2017b). Injury refers to damage to the body from some external force, such as from a car crash or a fall, including kinetic, chemical, electrical, thermal or other forces. There are multiple types of death from injury. Health researchers and policymakers classify injuries as unintentional or intentional, and if intentional, injury deaths are further classified as either suicide or homicide. Researchers and policymakers further categorize injuries by the mechanism or circumstances of the injury (such as motor vehicle crash, poisoning, or firearm)

Ebola and War in the Democratic Republic of Congo: Avoiding Failure and Thinking Ahead

The Ebola epidemic in the Democratic Republic of Congo (DRC) is exceptionally dangerous, occurring within active armed conflict and geopolitical volatility, including a million displaced persons. With 421 cases, 240 deaths, and the numbers increasing, this Ebola outbreak is the second deadliest in history. Recent spread to Butembo, home to 1.2 million people, raised concerns. The DRC, World Health Organization (WHO), and partners are leading a vigorous international response, yet despite deploying an experimental vaccine, cases doubled in October 2018 and many cases had unknown origin. Uncontrolled Ebola outbreaks can expand quickly, as occurred in West Africa in 2014. Averting that outcome in the DRC requires rapid action including a strengthened public health response, security, and community outreach. If violence escalates, it could compromise a fragile response. Yet resources are insufficient. The United States and other countries are not permitting personnel deployment to the epicenter, including from the Centers for Disease Control and Prevention (CDC) and US Agency for International Development (USAID). In this Viewpoint, we review recommendations of experts convened by Georgetown University and listed at the end of this article. The United States and international community should launch high-level political mobilization, with diplomatic, human, and economic resources. It is critical to recognize that future health crises will occur in fragile, insecure settings. To prepare, the international community needs long-term planning and enhanced capacities to improve the safety and effectiveness of epidemic response operations

The Modular Fiction of Ken Liu

Ken Liu is an influential translator of Chinese-language science fiction and an award winning author of original speculative fiction as well. His readers routinely observe that Liu draws on his Chinese heritage for world building and plot development. Less remarked upon are parallels between Liu’s creative process and modular production within Chinese literary and material culture. In this article, I explore these parallels through Liu’s wide-ranging fiction. The intent is not to pigeonhole Liu as a distinctly Chinese or Chinese American author – he has rejected such labels himself – but to universalize models of Chinese creative expression

School Influences on Parents’ Educational Expectations

This study seeks to determine the social origins of parents\u27 educational expectations for their children and explore how the effects of sociodemographic background characteristics differ across schools. Using data from the Early Childhood Longitudinal Study - Kindergarten (ECLS-K) and a multilevel approach, the results indicate that race, socioeconomic status (SES), child academic abilities, and school composition are all important predictors of parental educational expectations of 8th grade children. Having higher SES, being black or Hispanic, and attending a school with a high percentage of minority students all increase parental expectations. Furthermore, the positive effect of having higher levels of parental education or household income is weakened by attending a school with a higher level of students coming from a minority racial background. This study demonstrates that school effects extend beyond the child and that researchers should continue to explore family-school interactions

Surrogacy in California: Genetic and Gestational Rights

Part I of this article contrasts the surrogacy controversy in California with the legislative response nationwide by examining the various underlying issues that must necessarily be considered by state legislatures. Although the surrogacy controversy raises issues that concern the nation and society as a whole, it should be resolved independently by each state\u27s legislature. At the center of the debate lies the question of whether the practice of surrogacy is detrimental or beneficial to the contracting parties and to society. Part II examines a California judicial decision of first impression and compares it to other states\u27 judicial decisions on surrogacy. The California decision is indicative of the need for legislation in the state, as its results were not reached through an application of current laws. Furthermore, the decision and several legislative proposals reflect the conflict on surrogacy within the state. While its holding is supported by recently introduced legislation, it is directly at odds with the recommended legislation of the Advisory Panel\u27s Final Report to the Joint Legislative Committee on Surrogate Parenting. Legislation will serve to clarify the rights of parties to a surrogate parenting agreement

Decision-making impairment in emotional disorders

Decision-making has become the focus of increased scientific attention in recent years. Attempts to characterize decision-making deficits in unipolar mood and anxiety disorders have, however, produced conflicting results. The current study examined two types of impairment, indecisiveness and risky decision-making, in a clinical sample of individuals with depression and/or anxiety. Depression and obsessive-compulsive disorder (OCD) symptoms were hypothesized to predict both self-reported indecisiveness and decision latency on behavioral tasks, with processing speed partially mediating the relationship between psychopathology and decision latency. It was hypothesized that symptoms of OCD and generalized anxiety disorder (GAD) would predict advantageous performance on a task assessing risky decision-making, and that executive functioning would partially mediate the relationship between psychopathology and risky decision-making. A sample of individuals (N = 74) who had recently undergone semi-structured diagnostic interviews was recruited for the current study. All participants were diagnosed with at least one unipolar mood or anxiety disorder, with the majority meeting criteria for two or more disorders. All participants completed the same study protocol, which included self-report measures, neuropsychological tests, and computer-administered decision-making tasks. Regression analyses and latent growth modeling were used to examine associations between psychopathology, decision-making, and neuropsychological variables. Self-reported depressive symptoms and OCD symptoms predicted self-reported indecisiveness. Contrary to prediction, psychopathology (when measured dimensionally via self-report measures or operationalized as the presence or absence of a depressive disorder, GAD, or OCD) did not predict decision latency, and there was no evidence of a mediating effect of processing speed. Self-reported depressive symptoms, but not self-reported symptoms of GAD or OCD, were positively associated with ratings of decision difficulty. On a measure of risky decision-making, a diagnosis of GAD and poorer set-shifting were both associated with less improvement in performance over the course of the task, whereas a diagnosis of OCD was associated with more improvement. Results are discussed in the context of the decision-making literature. Methodological challenges to the study of decision-making are addressed and ideas for future research are proposed

Human Perceptions of Animals and Animal Awareness: The Cultural Dimension

Culture is generally a powerful determinant of human perceptions of animals and the treatment animals receive in a given society. Fbr example, Plains Indians\u27 views of the status of animals-their capacities, their awareness, and their place in the world relative to mankind-differ radically from those characteristic ofWestern thought. Many of the contemporary Crow Indians, a group of native Americans among which I have recently carried out anthropological field research, continue to look upon their horses according to traditional tribal belief. Their particular attitude toward horses conflicts with that of the dominant white society with which the Indians and their horses must interact. Mutual hostility results from a lack of understanding between members of the two cultures who, though living in proximity, remain worlds apart in ethos. Two other examples from ethnographic literature involving the habitual treatment of mules in a community of farmers and of sled dogs by a group of Eskimos also highlight the importance of cultural attitudes in affecting interactions with animals in those societies. It is vital to strive to understand the many complex factors which determine views toward animals, including their capacities for awareness, in alien cultures whose value-systems may be foreign to our own. Since human actions toward animals are rooted in perceptual concepts concerning the intrinsic nature of those animals, it is only through empathy resulting from understanding such concepts that a beginning can be made in solving the many problems involved in human relationships with animals

Web Resources for Physician Wellness

A current listing of websites, TED talks, and podcasts related to physician wellness and resiliency