352 research outputs found

    Criminal Justice and Suicide Outcomes with Indiana's Risk-Based Gun Seizure Law

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    This article examines the application and effectiveness of a 2006 Indiana law designed to prevent gun violence by authorizing police officers to separate firearms from persons who present imminent or future risk of injury to self or others, or display a propensity for violent or emotionally unstable conduct. A court hearing is held to determine ongoing risk in these cases; a judge decides whether to return the seized firearms or retain them for up to five years. The study examines the frequency of criminal arrest as well as suicide outcomes for 395 gun-removal actions in Indiana. Fourteen individuals (3.5%) died from suicide, seven (1.8%) using a firearm. The study population's annualized suicide rate was about 31 times higher than that of the general adult population in Indiana, demonstrating that the law is being applied to a population genuinely at high risk. By extrapolating information on the case fatality rate for different methods of suicide, we calculated that one life was saved for every 10 gun-removal actions, similar to results of a previous study in Connecticut. Perspectives from key stakeholders are also presented along with implications for gun policy reform and implementation

    Derivation of physically based soil hydraulic parameters in New Zealand by combining soil physics and hydropedology

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    Field-characterised soil morphological data (to 1 m depth) and modelled soil water release characteristics are recorded in the S-map database for soils cover- ing approximately 40% of New Zealand's soil area. This paper shows the devel- opment of the Smap-Hydro database that estimates hydraulic parameters by synergising soil morphologic data recorded in S-map and soil physics. The Smap-Hydro parameters were derived using the bi-modal Kosugi hydraulic function. The validity of the Smap-Hydro parameters was tested by applying them within an uncalibrated physically based hydrological model (HyPix) and comparing results with soil water content, θ, measured with Aquaflex soil moisture probes (0–40 cm deep) at 24 sites across New Zealand. The HyPix model provided an excellent fit with observed soil water content for 25% of the sites, a good fit for 33% of the sites and a poor fit for 42% of the sites. Applying the model to all soils in the S-map database required adjustments for the occurrence of rock fragments, hydraulic discontinuities caused by soil pans and required the addition of boundary conditions for water tables and the occurrence of impermeable rock. A discussion on how we can further syner- gise the development of pedotransfer functions with knowledge of soil physics is provided

    A system�based intervention to reduce Black�White disparities in the treatment of early stage lung cancer: A pragmatic trial at five cancer centers

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    Background: Advances in early diagnosis and curative treatment have reduced high mortality rates associated with non�small cell lung cancer. However, racial disparity in survival persists partly because Black patients receive less curative treatment than White patients. Methods: We performed a 5�year pragmatic, trial at five cancer centers using a system�based intervention. Patients diagnosed with early stage lung cancer, aged 18�85 were eligible. Intervention components included: (1) a real�time warning system derived from electronic health records, (2) race�specific feedback to clinical teams on treatment completion rates, and (3) a nurse navigator. Consented patients were compared to retrospective and concurrent controls. The primary outcome was receipt of curative treatment. Results: There were 2841 early stage lung cancer patients (16% Black) in the retrospective group and 360 (32% Black) in the intervention group. For the retrospective baseline, crude treatment rates were 78% for White patients vs 69% for Black patients (P < 0.001); difference by race was confirmed by a model adjusted for age, treatment site, cancer stage, gender, comorbid illness, and income�odds ratio (OR) 0.66 for Black patients (95% CI 0.51�0.85, P = 0.001). Within the intervention cohort, the crude rate was 96.5% for Black vs 95% for White patients (P = 0.56). Odds ratio for the adjusted analysis was 2.1 (95% CI 0.41�10.4, P = 0.39) for Black vs White patients. Between group analyses confirmed treatment parity for the intervention. Conclusion: A system�based intervention tested in five cancer centers reduced racial gaps and improved care for all

    Independent effects of HIV infection and cocaine dependence on neurocognitive impairment in a community sample living in the southern United States

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    Prior studies have established that methamphetamine and HIV can have additive deleterious effects on neurocognitive functioning, but there has been relatively little research on other stimulants like cocaine. This study investigated the effects of cocaine and HIV on neurocognitive impairment in a large, well-characterized sample

    Cerebellar c9RAN proteins associate with clinical and neuropathological characteristics of C9ORF72 repeat expansion carriers.

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    Clinical and neuropathological characteristics associated with G4C2 repeat expansions in chromosome 9 open reading frame 72 (C9ORF72), the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia, are highly variable. To gain insight on the molecular basis for the heterogeneity among C9ORF72 mutation carriers, we evaluated associations between features of disease and levels of two abundantly expressed "c9RAN proteins" produced by repeat-associated non-ATG (RAN) translation of the expanded repeat. For these studies, we took a departure from traditional immunohistochemical approaches and instead employed immunoassays to quantitatively measure poly(GP) and poly(GA) levels in cerebellum, frontal cortex, motor cortex, and/or hippocampus from 55 C9ORF72 mutation carriers [12 patients with ALS, 24 with frontotemporal lobar degeneration (FTLD) and 19 with FTLD with motor neuron disease (FTLD-MND)]. We additionally investigated associations between levels of poly(GP) or poly(GA) and cognitive impairment in 15 C9ORF72 ALS patients for whom neuropsychological data were available. Among the neuroanatomical regions investigated, poly(GP) levels were highest in the cerebellum. In this same region, associations between poly(GP) and both neuropathological and clinical features were detected. Specifically, cerebellar poly(GP) levels were significantly lower in patients with ALS compared to patients with FTLD or FTLD-MND. Furthermore, cerebellar poly(GP) associated with cognitive score in our cohort of 15 patients. In the cerebellum, poly(GA) levels similarly trended lower in the ALS subgroup compared to FTLD or FTLD-MND subgroups, but no association between cerebellar poly(GA) and cognitive score was detected. Both cerebellar poly(GP) and poly(GA) associated with C9ORF72 variant 3 mRNA expression, but not variant 1 expression, repeat size, disease onset, or survival after onset. Overall, these data indicate that cerebellar abnormalities, as evidenced by poly(GP) accumulation, associate with neuropathological and clinical phenotypes, in particular cognitive impairment, of C9ORF72 mutation carriers

    The prevalence and incidence of mental ill-health in adults with autism and intellectual disabilities

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    The prevalence, and incidence, of mental ill-health in adults with intellectual disabilities and autism were compared with the whole population with intellectual disabilities, and with controls, matched individually for age, gender, ability-level, and Down syndrome. Although the adults with autism had a higher point prevalence of problem behaviours compared with the whole adult population with intellectual disabilities, compared with individually matched controls there was no difference in prevalence, or incidence of either problem behaviours or other mental ill-health. Adults with autism who had problem behaviours were less likely to recover over a two-year period than were their matched controls. Apparent differences in rates of mental ill-health are accounted for by factors other than autism, including Down syndrome and ability level

    Long-term cognitive and behavioral consequences of neonatal encephalopathy following perinatal asphyxia: a review

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    Neonatal encephalopathy (NE) following perinatal asphyxia (PA) is considered an important cause of later neurodevelopmental impairment in infants born at term. This review discusses long-term consequences for general cognitive functioning, educational achievement, neuropsychological functioning and behavior. In all areas reviewed, the outcome of children with mild NE is consistently positive and the outcome of children with severe NE consistently negative. However, children with moderate NE form a more heterogeneous group with respect to outcome. On average, intelligence scores are below those of children with mild NE and age-matched peers, but within the normal range. With respect to educational achievement, difficulties have been found in the domains reading, spelling and arithmetic/mathematics. So far, studies of neuropsychological functioning have yielded ambiguous results in children with moderate NE. A few studies suggest elevated rates of hyperactivity in children with moderate NE and autism in children with moderate and severe NE. Conclusion: Behavioral monitoring is required for all children with NE. In addition, systematic, detailed neuropsychological examination is needed especially for children with moderate NE
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