After Roper v. Simmons: Keeping Kids Out of Adult Criminal Court

When children kill, as they always have and probably always will, the state must juggle two distinct and oftentimes conflicting concerns: its police power and its parens patriae interest. These concerns are not, however, mutually exclusive. There is a delicate balance that must be maintained. Clearly, the state must incapacitate and punish children who commit serious criminal acts, but, as Simmons says, that does not mean that minors can be executed, nor, as the Authors maintain, be consigned to living death behind bars without any hope of respite. The legal system must somehow be adjusted for children

GPs' strategies in intercultural clinical encounters

Background. In North America and Europe, patients and physicians are increasingly likely to come from non-Western cultural backgrounds. The expectations of these patients may not match those of physicians. Objective. To identify strategies used by GPs with patients from cultures other than their own. Methods. We conducted a qualitative inductive study based on 25 semi-structured interviews with family physicians practising in Montreal, Canada. We elicited physicians' strategies when dealing with patients from a cultural background different from their own. We began by asking physicians to describe an encounter they found difficult and one they found easy. Results. Physicians reported three types of strategies: (i) insistence on patient adaptation to local beliefs and behaviours; (ii) physician adaptation to what he or she assumed patients wanted; and (iii) negotiation of a mutually acceptable plan. Individual physicians did not adopt the same strategy in all situations. Their choice of strategy depended on the topic. When dealing with issues they felt deeply about, such as the autonomy of women, many physicians insisted on patient adaptation. Physicians used a patient-centred model of care, but had no framework to elicit information about patients' culture. Conclusions. A patient-centred model of care enables physicians to consult effectively despite a wide range of cultural differences between themselves and their patients. However, their lack of a conceptual framework for addressing cultural difference prevents systematic data collection and consideration of challenges to respect for individual autonomy. Physician training should include the provision of an explicit conceptual framework for approaching patients from a different cultur

A Few Thoughts on Evidence in Social Work

Social work practitioners must act every working day in the face of uncertainty. This uncertainty arises in part because knowledge is often difficult to locate or sometimes lacking regarding: the systems context the population being served; the particular client system; the set of problems the client system is experiencing; as well as the various interventions that could be selected. It seems reasonable to explore ways to reduce the experience of uncertainty, and narrow, if not eliminate, the knowledge gaps that arise in such situations. The generic idea of evidence based practice has been advanced for some time as an approach to support practitioners in their day to day work. This paper has two foci. First, it will briefly and selectively review attempts to make social work practice more evidence based. Second, it will describe one stage in the evolution of a web based service (Information for Practice [IP]). IP is a long term project with the mission of keeping practitioners informed about news and new scholarship in the field, so that they can more easily make their practice more evidenced based

The CB1 antagonist rimonabant (SR141716) blocks cue-induced reinstatement of cocaine seeking and other context and extinction phenomena predictive of relapse

Cannabinoid CB1 antagonists decrease self-administration of palatable food and several abused drugs in animals and modulate extinction of conditioned fear responses. Less is known, however, about whether and how CB1 antagonists might modulate the extinction of appetitive behavior. Therefore, this study examined the effects of the CB1 receptor antagonist rimonabant (SR141716) during extinction of responding maintained either by cocaine or by palatable foods (corn oil or Ensure), as well as responding elicited by stimulus cues that had been paired with the presentation of cocaine (i.e., cue-induced reinstatement) or a prime (presentation of cocaine or food). The effect of rimonabant on high rate responding in water-deprived mice trained to self-administer water was also examined. In mice self-administering cocaine, rimonabant attenuated cue-induced reinstatement of cocaine self-administration, the initial burst of responding during cocaine extinction and responding during spontaneous recovery. In mice self-administering corn oil, rimonabant decreased responding during extinction and also attenuated responding that had been reinstated by a priming presentation of corn oil. Moreover, mice treated with rimonabant required fewer daily sessions to reach criterion for extinction of cocaine-maintained responding than vehicle treated mice. Also, rimonabant had no effect on rate of operant responding in mice trained to respond for water under an FR5 schedule of reinforcement. Taken together, these data suggest that in addition to attenuating the primary reinforcing effects of both palatable foods and drugs of abuse, CB1 receptor antagonism can attenuate context and cue reactivity during extinction learning and potentially enhance extinction learning in this way

The Lantern Vol. 61, No. 1, December 1993

• In Order to Succeed • Essay • Power of Human Self-Interest: Man vs. Car • In Setterich • Wandering Wanda • Maybe Kitchens • Saltiness • Homecoming • Perfect • Sincerely, Jen • A Midterm and a Paper • Prophet Junkie • Soundless Memo • After Ireland, Part 1https://digitalcommons.ursinus.edu/lantern/1142/thumbnail.jp

Safety and immunogenicity of therapeutic DNA vaccination in individuals treated with antiretroviral therapy during acute/early HIV-1 infection

Background: An effective therapeutic vaccine that could augment immune control of HIV-1 replication may abrogate or delay the need for antiretroviral therapy. AIDS Clinical Trials Group (ACTG) A5187 was a phase I/II, randomized, placebo-controlled, double-blinded trial to evaluate the safety and immunogenicity of an HIV-1 DNA vaccine (VRC-HVDNA 009-00-VP) in subjects treated with antiretroviral therapy during acute/early HIV-1 infection. (clinicaltrials.gov NCT00125099) Methods: Twenty healthy HIV-1 infected subjects who were treated with antiretroviral therapy during acute/early HIV-1 infection and had HIV-1 RNA<50 copies/mL were randomized to receive either vaccine or placebo. The objectives of this study were to evaluate the safety and immunogenicity of the vaccine. Following vaccination, subjects interrupted antiretroviral treatment, and set-point HIV-1 viral loads and CD4 T cell counts were determined 17–23 weeks after treatment discontinuation. Results: Twenty subjects received all scheduled vaccinations and discontinued antiretroviral therapy at week 30. No subject met a primary safety endpoint. No evidence of differences in immunogenicity were detected in subjects receiving vaccine versus placebo. There were also no significant differences in set-point HIV-1 viral loads or CD4 T cell counts following treatment discontinuation. Median set-point HIV-1 viral loads after treatment discontinuation in vaccine and placebo recipients were 3.5 and 3.7 log[sub]10 HIV-1 RNA copies/mL, respectively. Conclusions: The HIV-1 DNA vaccine (VRC-HIVDNA 009-00-VP) was safe but poorly immunogenic in subjects treated with antiretroviral therapy during acute/early HIV-1 infection. Viral set-points were similar between vaccine and placebo recipients following treatment interruption. However, median viral load set-points in both groups were lower than in historical controls, suggesting a possible role for antiretroviral therapy in persons with acute or early HIV-1 infection and supporting the safety of discontinuing treatment in this group. Trial Registration: Clinicaltrials.gov NCT0012509

The Lantern Vol. 60, No. 2, Summer 1993

• Wake • Misconception • Cliche • Standard Oil • Lake Effect • Charlotte • Psychedelic Iridescent Infidelity • A Playground in Winter • Shooting Pool with Angels • The Blood Through Our Veins • Iced Coffee • Buzz Kill • Immortality • Cathodic Union • Crush • Mushrooms • Conversing • Eggplant • A Letter to the Civil Rights Movement • Still Sitting, Contemplating • Sensible Love • Monsters Under the Bed • Poison Rock • Waiting at the Dentist • Fate • Static • The Three C\u27s • As We Frolic • Nest • A Bottle of Wine and Patsy Cline • Bottoms of Pages, Backs of Bookshttps://digitalcommons.ursinus.edu/lantern/1143/thumbnail.jp