Conflicting Bureaucracies, Conflicted Work: Dilemmas in Case Management for Homeless People with Mental Illness

This ethnographic study finds a case management agency torn between the rules of two conflicting bureaucracies. Funded by a federal grant, the agency is administered by the county, and the regulations of the two systems turn out to be incompatible. This conflict creates dilemmas in providing services to clients: meeting eligibility criteria for services from the federal grant meant the clients did not meet the eligibility criteria for many County services. Agency staff reacted to this dilemma by bending rules, finding loopholes, and investing extra time and emotional labor in each client. The role-conflict engendered by bureaucratic disjunction creates frustration, resentment, and burnout within the agency

Pregnant and Poor in the Suburb: The Experiences of Economically Disadvantaged Women of Color with Prenatal Services in a Wealthy Suburban County

This study explores the perinatal care experiences of disadvantaged women of color in a wealthy U.S. suburb. The women were asked to discuss the availability of health and social services during pregnancy, continuity of provider and/or treatment, communication issues with their providers, and the amount and type ofsupport and resources available. Many of the questions covered in literature on urban poverty emerged as well in this suburban sample, including economic and psychosocial barriers, and continuity and communication issues between low-income/minority women and providers of health and social services. Additional barriers in the suburbs were also discussed, including problems of access to care and services, with health insurance/reimbursement or financial accessibility, transportation and housing, and getting needed information. Overall findings support the argument that suburban poverty is an overlooked issue contributing to health disparities in infant mortality

Factors driving inequality in prostate cancer survival: a population based study

As cancer control strategies have become more successful, issues around survival have become increasingly important to researchers and policy makers. The aim of this study was to examine the role of a range of clinical and socio-demographic variables in explaining variations in survival after a prostate cancer diagnosis, paying particular attention to the role of healthcare provider(s) i.e. private versus public status. Data were extracted from the National Cancer Registry Ireland, for patients diagnosed with prostate cancer from 1998-2009 (N = 26,183). A series of multivariate Cox and logistic regression models were used to examine the role of healthcare provider and socio-economic status (area-based deprivation) on survival, controlling for age, stage, Gleason grade, marital status and region of residence. Survival was based on all-cause mortality. Older individuals who were treated in a private care setting were more likely to have survived than those who had not, when other factors were controlled for. Differences were evident with respect to marital status, region of residence, clinical stage and Gleason grade. The effect of socio-economic status was modified by healthcare provider, such that risk of death was higher in those men of lower socio-economic status treated by public, but not private providers in the Cox models. The logistic models revealed a socio-economic gradient in risk of death overall; the gradient was larger for those treated by public providers compared to those treated by private providers when controlling for a range of other confounding factors. The role of healthcare provider and socio-economic status in survival of men with prostate cancer may give rise to concerns that warrant further investigation

An introduction to Trends in Extreme Weather and Climate Events: Observations, Socioeconomic Impacts, Terrestrial Ecological Impacts, and Model Projections

Weather and climatic extremes can have serious and damaging effects on human society and infrastructure as well as on ecosystems and wildlife. Thus, they are usually the main focus of attention of the news media in reports on climate. There are some indications from observations concerning how climatic extremes may have changed in the past. Climate models show how they could change in the future either due to natural climate fluctuations or under conditions of greenhouse gas-induced warming. These observed and modeled changes relate directly to the understanding of socioeconomic and ecological impacts related to extremes.Integrative Biolog

Effect of Monetary Incentives on Mail Survey Response Rates for Midwestern Farmers

Response rates to mail-based surveys have declined in recent decades, and survey response rates for farmers tend to be low overall. Maintaining high response rates is necessary to prevent non-response bias. Historically, incentives have been an effective tool to increase response rates with general populations. However, the effect of incentives on farmers has not been well tested. In this study, we experimentally manipulated the use of a $2 incentive in two surveys targeted at farmers. We tested both the use of the incentive and the timing of incentive distribution in the survey process. We found the incentive significantly increased response rates with farmers but there was no significant effect of when the incentive was distributed. Additionally, we evaluated the cost-effectiveness of using the incentive. While the incentive increased response rate, the cost per survey response also increased and the cost of the incentive was not offset by the increased response rate

A Novel Keratocan Mutation Causing Autosomal Recessive Cornea Plana

PURPOSE: Mutations in keratocan (KERA), a small leucine-rich proteoglycan, have recently been shown to be responsible for cases of autosomal recessive cornea plana (CNA2). A consanguineous pedigree in which cornea plana cosegregated with microphthalmia was investigated by linkage analysis and direct sequencing. METHODS: Linkage was sought to polymorphic microsatellite markers distributed around the CNA2 and microphthalmia loci (arCMIC, adCMIC, NNO1, and CHX10) using PCR and nondenaturing polyacrylamide gel electrophoresis before KERA was directly sequenced for mutations. RESULTS: Positive lod scores were obtained with markers encompassing the CNA2 locus, the maximum two-point lod scores of 2.18 at recombination fraction theta = 0 was obtained with markers D12S95 and D12S327. Mutation screening of KERA revealed a novel single-nucleotide substitution at codon 215, which results in the substitution of lysine for threonine at the start of a highly conserved leucine-rich repeat motif. Structural modeling predicts that the motifs are stacked into an arched beta-sheet array and that the effect of the mutation is to alter the length and position of one of these motifs. CONCLUSIONS: This report describes a novel mutation in KERA that alters a highly conserved motif and is predicted to affect the tertiary structure of the molecule. Normal corneal function is dependent on the regular spacing of collagen fibrils, and the predicted alteration of the tertiary structure of KERA is the probable mechanism of the cornea plana phenotype

Inhibition of HIV replication by amino-sugar derivatives

AbstractThe plant alkaloids castanospermine, dihydroxymethyldihydroxypyrrolidine and deoxynojirimycin have recently been shown to have potential anti-HIV activity [(1987) Proc. Natl. Acad. Sci. USA 84, 8120–8124; (1987) Nature 330, 74–77; (1987) Lancet i, 1025–1026]. They are thought to act by inhibiting α-glucosidase I, an enzyme involved in the processing of N-linked oligosaccharides on glycoproteins. We report here the relative efficacy of a spectrum of amino-sugar derivatives as inhibition of HIV cytopathicity. Several α-glucosidase inhibitors and α-fucosidase inhibitors were found to be active at concentrations which were non-cytotoxic

The translation research in a dental setting (TRiaDS) programme protocol

Background: It is well documented that the translation of knowledge into clinical practice is a slow and haphazard process. This is no less true for dental healthcare than other types of healthcare. One common policy strategy to help promote knowledge translation is the production of clinical guidance, but it has been demonstrated that the simple publication of guidance is unlikely to optimise practice. Additional knowledge translation interventions have been shown to be effective, but effectiveness varies and much of this variation is unexplained. The need for researchers to move beyond single studies to develop a generalisable, theory based, knowledge translation framework has been identified.For dentistry in Scotland, the production of clinical guidance is the responsibility of the Scottish Dental Clinical Effectiveness Programme (SDCEP). TRiaDS (Translation Research in a Dental Setting) is a multidisciplinary research collaboration, embedded within the SDCEP guidance development process, which aims to establish a practical evaluative framework for the translation of guidance and to conduct and evaluate a programme of integrated, multi-disciplinary research to enhance the science of knowledge translation.Methods: Set in General Dental Practice the TRiaDS programmatic evaluation employs a standardised process using optimal methods and theory. For each SDCEP guidance document a diagnostic analysis is undertaken alongside the guidance development process. Information is gathered about current dental care activities. Key recommendations and their required behaviours are identified and prioritised. Stakeholder questionnaires and interviews are used to identify and elicit salient beliefs regarding potential barriers and enablers towards the key recommendations and behaviours. Where possible routinely collected data are used to measure compliance with the guidance and to inform decisions about whether a knowledge translation intervention is required. Interventions are theory based and informed by evidence gathered during the diagnostic phase and by prior published evidence. They are evaluated using a range of experimental and quasi-experimental study designs, and data collection continues beyond the end of the intervention to investigate the sustainability of an intervention effect.Discussion: The TRiaDS programmatic approach is a significant step forward towards the development of a practical, generalisable framework for knowledge translation research. The multidisciplinary composition of the TRiaDS team enables consideration of the individual, organisational and system determinants of professional behaviour change. In addition the embedding of TRiaDS within a national programme of guidance development offers a unique opportunity to inform and influence the guidance development process, and enables TRiaDS to inform dental services practitioners, policy makers and patients on how best to translate national recommendations into routine clinical activities

Mainstreaming domestic and gender-based violence into sociology and the criminology of violence

Sociological and criminological views of domestic and gender-based violencegenerally either dismiss it as not worthy of consideration, or focus on specificgroups of offenders and victims (male youth gangs, partner violence victims). Inthis paper, we take a holistic approach to violence, extending the definition fromthat commonly in use to encompass domestic violence and sexual violence. Weoperationalize that definition by using data from the latest sweep of the CrimeSurvey for England and Wales. By so doing, we identify that violence is currentlyunder-measured and ubiquitous; that it is gendered, and that other forms of violence (family violence, acquaintance violence against women) are equally ofconcern. We argue that violence studies are an important form of activity forsociologists

Severe Community-acquired Pneumonia Due to Staphylococcus aureus, 2003–04 Influenza Season

S. aureus community-acquired pneumonia has been reported from 9 states