The Culture-Structure Framework: Beyond the Cultural Competence Paradigm

This article provides a framework for understanding the distinctions between culture and structure in its application to the human services. Using intimate partner violence (IPV) as a case study, this article builds upon the contributions of intersectionality, which was first introduced as a critique of white-dominated IPV interventions. It also follows the development of the concept of cultural competence to demonstrate the ways in which it both opened opportunities to discuss cultural differences but also suppressed the analysis of racialized hierarchies of power, which are often muted by the elevation of culture over race. Finally, this article proposes a general culture-structure framework that more clearly distinguishes the differences between culture and structure and provides analytical categories for looking at how culture and structure organize along lines of categories of identity and experience such as race/ethnicity, gender, class, sexuality, immigration status, ability, age, and religion. The framework also centers hierarchies of power, demonstrating how dominant individuals and groups often have both cultural dominance and greater control over and access to structural resources

Evaluating duration of response to treatment in systemic lupus erythematosus clinical trials.

ObjectiveTo evaluate response duration and identify predictors of transitioning into and out of the response state in patients with SLE receiving standard of care (SoC) in 52-week clinical trials.MethodsA multistate model (MSM) allowing for bidirectional transitions between response and non-response states was fit to data on 759 patients with SLE with active disease randomised to SoC. The probability of being in response at 52 weeks, average duration of response (sojourn time) and mean total time in response for SLE Responder Index (SRI-4, SRI-5, SRI-6) and BILAG-based Composite Lupus Assessment (BICLA) were estimated. Predictors of attainment and loss of SRI-5 response were also assessed.ResultsThe MSM estimated probability of being in response at 52 weeks ranged from 42% (SRI-6) to 61% (SRI-4). Mean duration of response ranged from 20.4 weeks (BICLA) to 31.5 weeks (SRI-4). Mean total time in response was 16.4-24.8 weeks. Baseline characteristics predictive of shorter SRI-5 response duration were African descent (p=0.005), longer history of disease (p=0.03), higher anti-dsDNA antibody titres (p=0.039), lower lymphocyte count (p=0.008) and lower haemoglobin (p=0.006). Younger age (p<0.001) and higher protein/creatinine ratio (p<0.001) were associated with higher likelihood of achieving SRI-5 but also shorter response duration.ConclusionFactors associated with disease severity were more predictive of shorter response duration than of 52-week response status. Analysing landmark response rates and response duration using MSM may be a more powerful way to distinguish effective investigational treatments from background SoC, although this remains to be evaluated in future trials

Brain Differences in the Prefrontal Cortex, Amygdala, and Hippocampus in Youth with Congenital Adrenal Hyperplasia

Context: Classical Congenital Adrenal Hyperplasia (CAH) due to 21-hydroxylase deficiency results in hormone imbalances present both prenatally and postnatally that may impact the developing brain. Objective: To characterize gray matter morphology in the prefrontal cortex and subregion volumes of the amygdala and hippocampus in youth with CAH, compared to controls. Design: A cross-sectional study of 27 CAH youth (16 female; 12.6 ± 3.4 year) and 35 typically developing, healthy controls (20 female; 13.0 ± 2.8 year) with 3-T magnetic resonance imaging scans. Brain volumes of interest included bilateral prefrontal cortex, and nine amygdala and six hippocampal subregions. Between-subject effects of group (CAH vs control) and sex, and their interaction (group-by-sex) on brain volumes were studied, while controlling for intracranial volume (ICV) and group differences in body mass index and bone age. Results: CAH youth had smaller ICV and increased cerebrospinal fluid volume compared to controls. In fully-adjusted models, CAH youth had smaller bilateral, superior and caudal middle frontal volumes, and smaller left lateral orbito-frontal volumes compared to controls. Medial temporal lobe analyses revealed the left hippocampus was smaller in fully-adjusted models. CAH youth also had significantly smaller lateral nucleus of the amygdala and hippocampal subiculum and CA1 subregions. Conclusions: This study replicates previous findings of smaller medial temporal lobe volumes in CAH patients, and suggests that lateral nucleus of the amygdala, as well as subiculum and subfield CA1 of the hippocampus are particularly affected within the medial temporal lobes in CAH youth

Penyertaan Wanita dalam Politik Parlimen Post-Soeharto di Indonesia

Artikel ini membincangkan tentang penyertaan wanita dalam pilihan raya di Indonesia setelah pentadbiran Presiden Soeharto. Penyertaan wanita dalam pilihan raya melalui isu kuota bermula pada tahun 2004. Pengumpulan data dengan cara kualitatif yang disokong data kuantitatif. Dokumen paper ini menjelaskan dua faktor dinamik dalam penyertaan wanita pada politik parlemen. Pertama faktor undang-undang dan polisi, kedua faktor parti politik dalam rekrutmen wanita. Hasil penyelidikan ini menjelaskan bahawa pilihan raya 2004, 2009, 2014, dan 2019 relatif meningkat jumlah bilangan wanita masuk parlemen. Hal ini disokong oleh perubahan undang-undang pilihan raya yang menyatakan bahwa wanita wajib disertakan dalam senarai calon sekurangnya 30% dan satu daripada tiga calon wajib ada wanita. Undang-undang ini adalah perubahan dari kata “cadangan” menjadi “wajib” dalam menetapkan calon. Ayat wajib itu menjadi penting dalam perubahan peningkatan bilangan wanita terpilih. Selain faktor undang-undang ada faktor parti kader yang menjadi catatan isu iaitu tidak maksimalnya parti dalam sistim rekrutmen. Kurangnya wanita parti kader yang cekap dalam politik menjadikan parti merekrut wanita segera pada masa pendaftaran calon. Wanita-wanita yang dipilih adalah mereka yang terkait dengan keluarga elit politik. Wanita yang datang dari elit politik ini dianggap berpeluang menang dalam pilihan raya kerana mereka mempunyai modal dan jaringan yang kuat. Keadaan ini juga sering menepikan wanita yang sudah lama aktif dalam parti tapi tidak cukup modal untuk kempen. Nombor satu dalam senarai calon di kertas undi menjadi penting kerana mereka yang terpilih pada tiap pilihan raya lebih dari limapuluh peratus namanya di nombor satu, isu ini yang juga sering menepikan wanita

Victim compensation: a child of penal welfarism or carceral policies

Abstract SwedishUnder efterkrigstiden förändrades många västerländska länders kriminalpolitik i riktning mot välfärd och rehabilitering. Detta ideal fokuserade gärningsmannen, inte brottsoffret. Detta skulle snart komma att förändras. En av de första initiativ som togs för brottsoffer var brottsskadeersättning, en ekonomisk kompensation som infördes på 1960-talet. Denna artikel jämför utvecklingen av brottsskadeersättningi två länder, USA och Sverige, i relation till deras välfärds- och kriminalpolitik. Båda länderna initierade kompensationsreformer för brottsoffer ivälfärdsinstitutionella kontexter. Med stöd i en jämförande historisk fallstudiemetod visar artikeln dock att kompensationsreformerna i de två länderna skilde sig åt och kom att avspegla respektive lands välfärds- och kriminalpolitik. De första svenska kompensationsreformerna förankrades som en socialförsäkringsfråga, medan deras motsvarigheter i USA snabbt banade väg för mer straffinriktade program.Abstract EnglishIn the post-war period, many Westernized countries advanced toward more rehabilitative and welfarist ideals informing crime policies. These ideals centered on the offending individual, not the victim. This was soon to change. Victim compensation programs were one of the first initiatives taken for victims of crime with the first established in the 1960s. This paper examines and compares the development of victim compensation programs in two countries with contrasting social welfare and penal policies, the United States and Sweden. Both countries developed victim compensation programs located within welfarist administrative institutions, suggesting common penal welfare frameworks and instruments. Using the comparative historical case study method, the study finds that formative victim compensation policies in the two countries differed widely, reflecting social welfare versus remedial welfare policies, and rehabilitative versus punitive carceral frameworks, respectively. Arguments upholding penal welfarist ideals and social insurance concerns underlay the early formation of Sweden’s victim compensation program and anchored subsequent developments while, in the United States, political conditions led to a rapid trajectory in more punitive directions

Brain Differences in the Prefrontal Cortex, Amygdala, and Hippocampus in Youth with Congenital Adrenal Hyperplasia

Context: Classical Congenital Adrenal Hyperplasia (CAH) due to 21-hydroxylase deficiency results in hormone imbalances present both prenatally and postnatally that may impact the developing brain. Objective: To characterize gray matter morphology in the prefrontal cortex and subregion volumes of the amygdala and hippocampus in youth with CAH, compared to controls. Design: A cross-sectional study of 27 CAH youth (16 female; 12.6 ± 3.4 year) and 35 typically developing, healthy controls (20 female; 13.0 ± 2.8 year) with 3-T magnetic resonance imaging scans. Brain volumes of interest included bilateral prefrontal cortex, and nine amygdala and six hippocampal subregions. Between-subject effects of group (CAH vs control) and sex, and their interaction (group-by-sex) on brain volumes were studied, while controlling for intracranial volume (ICV) and group differences in body mass index and bone age. Results: CAH youth had smaller ICV and increased cerebrospinal fluid volume compared to controls. In fully-adjusted models, CAH youth had smaller bilateral, superior and caudal middle frontal volumes, and smaller left lateral orbito-frontal volumes compared to controls. Medial temporal lobe analyses revealed the left hippocampus was smaller in fully-adjusted models. CAH youth also had significantly smaller lateral nucleus of the amygdala and hippocampal subiculum and CA1 subregions. Conclusions: This study replicates previous findings of smaller medial temporal lobe volumes in CAH patients, and suggests that lateral nucleus of the amygdala, as well as subiculum and subfield CA1 of the hippocampus are particularly affected within the medial temporal lobes in CAH youth

Effects of informative and confirmatory feedback on brain activation during negative feedback processing

The current study compared the effects of informative and confirmatory feedback on brain activation during negative feedback processing. For confirmatory feedback trials, participants were informed that they had failed the task, whereas informative feedback trials presented task relevant information along with the notification of their failure. Fourteen male undergraduates performed a series of spatial-perceptual tasks and received feedback while their brain activity was recorded. During confirmatory feedback trials, greater activations in the amygdala, dorsal anterior cingulate cortex, and the thalamus (including the habenular) were observed in response to incorrect responses. These results suggest that confirmatory feedback induces negative emotional reactions to failure. In contrast, informative feedback trials elicited greater activity in the dorsolateral prefrontal cortex (DLPFC) when participants experienced failure. Further psychophysiological interaction (PPI) analysis revealed a negative coupling between the DLPFC and the amygdala during informative feedback relative to confirmatory feedback trials. These findings suggest that providing task-relevant information could facilitate implicit down-regulation of negative emotions following failure