Gendered Violence in Indigenous Communities: A Restorative Justice Approach

In 1996, the Canadian government implemented reforms to the Criminal Code regarding sentencing in an attempt to reduce the overpopulation of Indigenous people in the judicial system, a problem which was seen as partly a result of colonialism and systemic discrimination. Included in these amendments were the restorative justice principles of reparations and responsibility, and a requirement for sentencing judges to consider reasonable alternatives to imprisonment, especially for Indigenous offenders. Unfortunately, a review of the recent literature indicates that judicial reform and sentencing innovation have failed to mitigate the overrepresentation of Indigenous people in the incarcerated population. It is apparent that what these reforms have failed to address are the broader systemic issues, such as poverty and lack of education, that contribute to the high incidence of Indigenous people committing criminal offences. Restorative justice has many goals, including enhancing accountability for one’s actions, increasing voluntary dialogue, and reconnecting the individual with the traditional community. However, these actions also need to be targeted at preventative measures, rather than focusing on sentencing and offender reintegration. Thus, in order for a restorative justice approach to legal issues to be effective, social workers have an obligation to strive for the creation of more programs specifically targeted at Indigenous people, especially those for women and youth

Motility induced changes in viscosity of suspensions of swimming microbes in extensional flows

Suspensions of motile cells are model systems for understanding the unique mechanical properties of living materials which often consist of ensembles of self-propelled particles. We present here a quantitative comparison of theory against experiment for the rheology of such suspensions. The influence of motility on viscosities of cell suspensions is studied using a novel acoustically-driven microfluidic capillary-breakup extensional rheometer. Motility increases the extensional viscosity of suspensions of algal pullers, but decreases it in the case of bacterial or sperm pushers. A recent model [Saintillan, Phys. Rev. E, 2010, 81:56307] for dilute active suspensions is extended to obtain predictions for higher concentrations, after independently obtaining parameters such as swimming speeds and diffusivities. We show that details of body and flagellar shape can significantly determine macroscale rheological behaviour.Comment: 12 pages, 1 appendix, 7 figures, submitted to Soft Matter - under revie

The Anatomy of EMTALA: A Litigator\u27s Guide.

The Emergency Medical Treatment and Active Labor Act (EMTALA) prohibits hospitals from inappropriately transferring or refusing medical care to persons with emergency medical conditions. EMTALA was passed in response to the practice of “dumping” seriously ill patients from private hospitals into public ones, to ensure all patients receive medical treatment in emergency situations. Plaintiffs have attempted to pursue EMTALA claims against non-hospital defendants, but courts have consistently disallowed such claims under the statute. By limiting the scope of its coverage to hospitals, EMTALA creates a situation unique from ordinary medical malpractice. Although hospitals may be held liable for negligent credentialing or supervision of physicians, hospitals are ordinarily not liable for physicians’ conduct or alleged medical malpractice. Under EMTALA, a hospital is liable for the emergency medicine physician’s conduct and decisions, because hospitals can only act by relying on the actions of its licensed physicians and hospital staff. EMTALA does not make physicians agents of the hospital for any purpose other than conduct specified by the statute and does not impute the physician’s tortious conduct regarding diagnosis and treatment to the hospital. Attorneys litigating EMTALA cases must have a clear understanding of the nature and application of every provision in the statute to provide proper representation. A hospital’s conduct must be evaluated based on the specific duty of care associated with each provision of the statute. In contrast, a determination of whether a hospital has breached the duty to stabilize a patient’s condition prior to transfer utilizes a more objective standard. This standard focuses on whether deterioration of the patient’s condition was likely to occur within reasonable medical probability. Though plaintiffs often seek to interject standards of liability based on negligence or medical malpractice, Congress did not intent for EMTALA to address injuries already redressed by state law

Implementation of a Rapid Assessment Unit (Intake Team): Impact on Emergency Department Length of Stay

Implementation of a Rapid Assessment Unit (Intake Team): Impact on Emergency Department Length of Stay Richard S. MacKenzie, MD, David B. Burmeister, DO, Jennifer A. Brown, RN, Melissa Teitsworth, RN, BSN, Christopher J. Kita, MEd, Megan J. Dambach, DO, Shaheen Shamji, DO, Anita Kurt, PhD, RN , Susan Friend, Marna Greenberg, DO, MPH Acknowledge: Clare M. Lenhart, PhD, MPH Objective: Emergency Department (ED) crowding is an on-going formidable issue for many EDs. A Rapid Assessment Unit (RAU) is a potential solution. This process involves the use of a team approach to convert the current “series” type evaluation to a more “parallel” evaluation and treatment of patients. The RAU concept of evaluating and treating ED patients radically changes the current methods utilized in today’s standard emergency care area. The RAU concept offers a process in which the patient walks into the ED and is seen in a unit by an intake team composed of a nurse, registrar, and provider (physician assistant, nurse practitioner, or physician) that provides evaluation and emergent treatment. This removes the redundancy of a patient giving the same information several times before they are treated. Simultaneously, the team decides whether the patient would be better served by remaining seated or requires a recumbent position. This is referred to as allowing “vertical flow” versus the default “horizontal flow” where all patients recline on a stretcher whether they need it or not. Certainly, having construction that specifically supports these processes is an innovation as well (having an area where patients can be seated and remain “vertical”). The team structure itself is unique. The nurses and providers are not assigned geographically by room but rather are defined by their function. We set out to determine if the addition of the RAU process would decreases the LOS of the discharged ambulatory arrival patient. Methods: After IRB approval, this retrospective, pre- and post intervention, observational comparison study was conducted from August 2011-March 2012 at a suburban teaching hospital in central Pennsylvania with an annual ED census of approximately 54,000. The inclusion criteria were all ambulatory discharged patients. The exclusion criteria were all patients that arrived by ambulance and admitted patients. Data points captured included: time of arrival in triage , time in triage to ED entry, time of ED entry until seen by a provider, time from ED entry to discharge, total length of stay (LOS). The data were uploaded to Horizon Business Insight™ (HBI), a cumulative data manager and exported to an Microsoft excel file for analysis. Mann-Whitney U tests were used to demonstrate differences in Median LOS. All statistical tests were 2-sided; probability values \u3c0.05 were considered significant. Results: 11, 994 pre and 10814 post-RAU patients were included in analysis. Median LOS was shorter during the post-RAU period in each subcategory of LOS with the exception of the interval from being seen in the ER to discharge which is a result of provider seeing the patient earlier in the ED encounter. Results, Table 1. Conclusions: The RAU process decreases the LOS of the discharged ambulatory arrival patient and deserves further exploration as an innovative model in the ED that improves flow

Common Sense Recommendations for the Application of Tax Law to Digital Assets

In response to the Joint Committee on Taxation’s July 2023 request for comments on application of various Internal Revenue Code sections on digital assets, we propose a consistent set of rules to apply current law to digital assets. We highlight that the underlying economics and characteristics of transactions should be the primary concern for the application of rules and the valuation of digital assets. We believe any digital asset rules should (1) treat classes of digital assets with unique characteristics differently based on their economics, (2) minimize incentives for users to engage in tax-motivated structuring of transactions, and (3) allow the Internal Revenue Service authority to react to and regulate new classes of digital assets as they are created. We do not believe that the unique features of digital assets are a challenge to applying current law or warrant special tax preferred treatment

Women and ARVâ based prevention: opportunities and challenges

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138349/1/jia29419.pd

Somatic mutations affect key pathways in lung adenocarcinoma

Determining the genetic basis of cancer requires comprehensive analyses of large collections of histopathologically well- classified primary tumours. Here we report the results of a collaborative study to discover somatic mutations in 188 human lung adenocarcinomas. DNA sequencing of 623 genes with known or potential relationships to cancer revealed more than 1,000 somatic mutations across the samples. Our analysis identified 26 genes that are mutated at significantly high frequencies and thus are probably involved in carcinogenesis. The frequently mutated genes include tyrosine kinases, among them the EGFR homologue ERBB4; multiple ephrin receptor genes, notably EPHA3; vascular endothelial growth factor receptor KDR; and NTRK genes. These data provide evidence of somatic mutations in primary lung adenocarcinoma for several tumour suppressor genes involved in other cancers - including NF1, APC, RB1 and ATM - and for sequence changes in PTPRD as well as the frequently deleted gene LRP1B. The observed mutational profiles correlate with clinical features, smoking status and DNA repair defects. These results are reinforced by data integration including single nucleotide polymorphism array and gene expression array. Our findings shed further light on several important signalling pathways involved in lung adenocarcinoma, and suggest new molecular targets for treatment.National Human Genome Research InstituteWe thank A. Lash, M.F. Zakowski, M.G. Kris and V. Rusch for intellectual contributions, and many members of the Baylor Human Genome Sequencing Center, the Broad Institute of Harvard and MIT, and the Genome Center at Washington University for support. This work was funded by grants from the National Human Genome Research Institute to E.S.L., R.A.G. and R.K.W.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62885/1/nature07423.pd