Slipping the Surly Bonds of the Medical/Rehabilitation Model In Expert Witness Testimony

This essay asserts that the new academic discipline of disability studies challenges the medical/rehabilitation models of disability and that this challenge has an impact on expert witness testimony. This assertion is based on the author’s experience in a civil sexual assault trial involving a male resident of a group home facility assaulted by another male resident of the group home. The author was surprised to find that her status as a visiting professor in the new academic discipline of disability studies trumped the testimony of the clinical expert witnesses, including a licensed psychologist, a behavioral specialist, and a case manager

Criterion-based screening for sexually transmitted infection: sensitivity, specificity, and predictive values of commonly used questions

pre-printBackground: Practice protocols that mandate pre-screening for sexually transmitted infection prior to insertion of an intrauterine device for contraception can pose obstacles for women seeking this highly effective method of birth control. Some practices screen for presumed risk factors for sexually transmitted infection in order to identify those who may be infected, or those in whom laboratory testing should be obtained. The value of such criterion-based screening is unclear. Design: Data from a prospective observational trial of offering the copper intrauterine device for emergency contraception were used to assess the value of several screening questions in predicting the presence of sexually transmitted infection. Criteria evaluated were age under 25, history of a sexually transmitted infection, and having 2 or more sexual partners in the previous 3 months. The sensitivity, specificity, and likelihood ratio of both positive and negative tests, and positive and negative predictive values were calculated for three separate questions, as well as for combinations of these three questions. Results: There were 197 women who received a copper intrauterine device for emergency contraception at the same time they were tested for sexually transmitted infection. In this sample, there were 8 cases of Chlamydia trachomatis identified, and no cases of Neisseria gonorrhea. The sensitivity of individual and combined questions in identifying those who were infected ranged from 0 to 88%; specificity ranged from 37-97%. The positive predictive values for single or combined screening questions were in the range of 4-6%. Likelihood ratios for both positive and negative tests did not change post-test likelihood of disease in any appreciable way

Extended and continuous combined contraceptive regimens for menstrual suppression

pre-printMany women have medical indications for menstrual suppression or a personal preference to reduce or eliminate monthly bleeding, which can be achieved with extended and continuous regimens of combined estrogen and progestin contraceptives. Combined contraceptives are traditionally administered in a 28-day cycle with 21 days of a contraceptive pill, vaginal ring, or transdermal patch followed by a hormone-free interval that is usually 7 days. During the hormone-free interval, women either take a placebo pill or do not use their combined contraceptive method. Hormone-related symptoms are higher during the hormone-free interval than the days when the contraceptive is used. Alterations of the standard 28-day cyclic regimen for menstrual suppression include decreasing the frequency of the hormone-free interval, thus extending the time between withdrawal bleeding episodes (extended use), and eliminating the hormone-free interval altogether (continuous use). This article reviews menstrual suppression indications and physiology. Research demonstrating that the effectiveness, safety, and side effects of oral, vaginal, and transdermal extended and continuous regimens are comparable to cyclic regimens is summarized. Findings from studies of women's and health care providers' attitudes toward menstrual suppression are also reviewed. Important topics to include in evidence-based counseling for extended and continuous combined contraceptive use are presented

Zincate-free, electroless nickel deposition on aluminum bond pads

A zincate-free electroless nickel deposition on aluminum bond pads is investigated. A three-step, etch, rinse, and electroless plating, is demonstrated for deposition on aluminum bond pads patterned with polyimide. The chemicals used are compatible with this dielectric material. The deposition has been achieved with good selectivity, uniformity, and deposition rate at 40 × 40   μ m aluminum bond pads. The adhesion and contact resistance were also determined and improved through anneals in the range 200-400°C for 1 h. The optimized condition for adhesion and contact resistance was an anneal at 400°C. The combination of a nickel hypophosphite reducing agent and the additives used leads to an active plating bath in the early stages of deposition, by comparison with commercial solutions, and hence, good coverage of the aluminum bond pad using the simplified process

Using Advanced Instructional Technology To Enhance Pesticide Applicator Training Programs

As public concern over the use of pesticides grows, the need for properly trained applicators becomes more important

Positive lifestyle changes around the time of pregnancy:a cross-sectional study

OBJECTIVES: To examine the prevalence of positive lifestyle behaviours before and during pregnancy in Ireland. DESIGN: Cross-sectional study. SETTING: Population-based study in Ireland. PARTICIPANTS: A total of 718 women of predominantly Caucasian origin from the Pregnancy Risk Assessment Monitoring System (PRAMS), Ireland, were included. PRIMARY AND SECONDARY OUTCOME MEASURES Positive lifestyle behaviour changes before and during pregnancy in Ireland on alcohol consumption, smoking, folate use and nutrition. RESULTS: Of 1212 women surveyed, 718 (59%) responded. 26% were adherent to all three recommendations on alcohol consumption, smoking and folate use before pregnancy. This increased to 39% for the same three behaviours during pregnancy, with greater increases in adherence observed among women with the lowest adherence before pregnancy. Age, education and ethnicity gaps in adherence before pregnancy appeared to narrow during pregnancy. Adherence to all seven food pyramid guidelines was less than 1% overall, and less than 1% of participants met all four micronutrient guidelines on vitamin D, folate, calcium and iron intake around the time of pregnancy. CONCLUSIONS: Low levels of healthy lifestyle behaviours before pregnancy and low levels of positive lifestyle behaviours during pregnancy demonstrate an urgent need for increased clinical and public health efforts to target deleterious health behaviours before, during and after pregnancy