The Python's Embrace: Clinical Research Regulation by Institutional Review Boards

http://dx.doi.org/10.1542/peds.2011-345

The Adolescent Smoking Prevention Project: A Web-Based Smoking Prevention for Adolescents

In 2014 2.5% of middle school students and 9.2% of high school students reported smoking cigarettes in the past 30 days (CDC, 2014). However, there is currently a lack of evidence-based programs targeting prevention of adolescent smoking. The current study evaluated the effectiveness of a novel web-based adolescent smoking prevention program, the Adolescent Smoking Prevention Project (ASPP), based on the sensitization-homeostasis theory of nicotine dependence and developed by the study investigators. A sample of 54 adolescents (aged 12-15) were recruited from public schools in Southern California. Of these adolescents 26 were randomly assigned to the ASPP program and 28 were randomly assigned to the control group. Results of two-way ANOVAs indicated that the intervention group endorsed greater positive smoking expectancies compared to the control group. Results of hierarchical multiple linear regression analyses indicated that resistance self-efficacy significantly predicted participants’ willingness to try a cigarette if offered and to refuse an offer of a cigarette. Furthermore, both negative social impressions and negative affect reduction expectancies significantly predicted participants’ willingness to leave the situation if offered a cigarette. Gender, resistance self-efficacy and social facilitation outcome expectancies (OEs) significantly predicted participants’ intentions to smoke in the future. These results suggest that positive smoking expectancies and benefits need to be targeted in prevention/intervention efforts in order to reduce adolescents’ susceptibility to smoking. When designing smoking prevention programs, content should target multiple factors in order to have a significant impact on smoking behavior of adolescents. Future research should continue to evaluate the effectiveness of the ASPP intervention in order to determine whether this innovative approach to addiction education and smoking prevention is effective and should be more widely disseminated

Neighborhood Rezonings and Historic Preservation In New York City

This thesis critically examines how historic preservation and heritage resources are considered in the process of large-scale neighborhood rezonings in New York City. In particular, this research addresses the ongoing city-led effort to identify and rezone fifteen neighborhoods throughout the five boroughs as part of Housing New York, an initiative that began in 2014 with the stated goal to create or preserve 300,000 units affordable housing within 10 years. Each of the rezonings began with an extensive neighborhood planning process that aimed to engage the community to achieve more equitable outcomes. While this approach is more constructive than the planning initiatives of the mid-twentieth century (such as urban renewal), the process is not fully accounting for the positive impacts historic preservation can have within the communities it seeks to improve. In neighborhoods that expressed concerns over the loss of important cultural resources, few formal measures were put in place to protect them. In East New York, Brooklyn, where a zoning amendment was approved in 2016, only one property was designated as a landmark as a result of the rezoning process, despite community assertions that the area contained dozens of potentially-eligible historic resources. The Manhattan neighborhoods of East Harlem and Inwood fared similarly when they were rezoned in 2017 and 2018. This thesis examines the first five neighborhoods rezoned under Housing New York to both document and better understand the process by which these rezonings are undertaken. Interviews with key stakeholders, including city officials and local preservationists provided insight regarding preservation concerns that existed in the neighborhood prior to the rezoning, whether and how those concerns were addressed, and what outcomes were for the community. The purpose of this thesis is to draw attention to a gap in the process and make recommendations for change that are more inclusive of heritage resources

“Among the Graves”: Constructing Community, Resistance, and Freedom on Nineteenth Century Plantation Burial Grounds

This paper examines the uses of plantation burial grounds by enslaved people. Drawing on the testimony in the Works Progress Administration Slave Narratives and nineteenth century narratives written by formerly enslaved people, I locate the grave as a space of resistance where enslaved people formed community, deliberately resisted plantation owner demands, and reinterpreted the meaning of freedom. In Chapter One, I identify the uses of burials grounds for funerals. From looking after the body, and preparing it, to traveling from other plantations to attend wakes and funerals, enslaved people transformed burial grounds into a space for community and the unbridled expressions of lamentation to escape enslavement. In relation to other spaces and practices on the plantation, enslaved people could gather there more openly and without as much oversight or secrecy. However, some plantation owners enacted restrictions around funerals, denying enslaved people the time to observe a death or the ability to conduct funerals. In Chapter Two, I discuss how enslaved people resisted these constraints and conducted funerals in whatever ways that they could. In extreme cases, owners responded violently to their gathering on burial grounds, but amid the contestations, enslaved people interpreted the space, not as a site of violence and death, but as one of escape and refuge. In Chapter Three, I explore how enslaved people used burial grounds to interpret freedom. In the graveyard, some hoped to find freedom in death, and reunion in afterlife

Degree of Vocal Handicap in Two Age Groups of Individuals

A healthy, functional voice is a critical aspect of daily life, allowing the expression of basic needs as well as interaction within an individual’s community. Unfortunately, for many adults the voice declines in later life. The purpose of this study was to investigate how normal vocal aging affects the quality of life of the elderly. Two hundred two adults without voice disorders from two age groups (30-50 and 65-85) completed the Voice Handicap Index. Results indicated that the older group felt a greater degree of vocal handicap than the younger age group [F (1,156) = 4.944, p = 0.028]. Implications of the study for care of the aging voice and areas for further research are discussed

Benefit Plan Design and Prescription Drug Utilization Among Asthmatics: Do Patient Copayments Matter?

Objective: The ratio of controller to reliever medication use has been proposed as a measure of treatment quality for asthma patients. In this study we examine the effects of plan level mean out-of-pocket asthma medication patient copayments and other features of benefit plan design on the use of controller medications alone, controller and reliever medications (combination therapy), and reliever medications alone. Methods: 1995-2000 MarketScan claims data were used to construct plan-level out-of-pocket copayment and physician/practice prescriber preference variables for asthma medications. Separate multinomial logit models were estimated for patients in fee-for-service (FFS) and non-FFS plans relating benefit plan design features, physician/practice prescribing preferences, patient demographics, patient comorbidities and county-level income variables to patient-level asthma treatment patterns. Results: We find that the controller reliever ratio rose steadily over 1995-2000, along with out-of-pocket payments for asthma medications, which rose more for controllers than for relievers. However, after controlling for other variables, plan level mean out-of-pocket copayments were not found to have a statistically significant influence upon patient-level asthma treatment patterns. On the other hand, physician practice prescribing patterns strongly influenced patient level treatment patterns. Conclusions: There is no strong statistical evidence that higher levels of out-of-pocket copayments for prescription drugs influence asthma treatment patterns. However, physician/practice prescribing preferences influence patient treatment.

Toward Competitive Employment for Persons with Intellectual and Developmental Disabilities: What Progress Have We Made and Where Do We Need to Go

Progress toward competitive integrated employment (CIE) for people with intellectual and developmental disabilities (IDD) over the last 40 years has been mixed. Despite evidence showing that supported employment interventions can enable adults with IDD to effectively get and keep jobs, national rates of integrated employment remain below a third of the working-age population. Progress is being made to improve these outcomes. Pathways have been identified that lead to CIE through supported employment, customized employment, internship experiences, and postsecondary education. The recent passage of the Workforce Innovation and Opportunity Act (WIOA) has created fresh momentum and increased the onus on interagency collaboration. This article examines what is known about promoting CIE through these pathways and highlights recommendations for future research and policy change. Recommendations for the future provide direction toward positive change for CIE into the 21st century

Strengths Model for Youth: Moving toward a Client-Centered, Strengths-based Model of Case Management in Community Mental Health

Approximately 13 to 20% of U.S. children and adolescents experience a mental disorder in a given year (Perou et al., 2013), with only half of these youth receiving mental health care (Kataoka, Zhang, & Wells, 2002; Merikangas, Nakamura, & Kessler, 2009). Even when children do access mental health services, approximate- ly 40% to 60% discontinue before completing their treatment (Baruch, Vrouva, & Fearon, 2009; Hoste, Zaitsoff, Hewell & le Grange, 2007; Miller, Southam-Gerow & Allin, 2008; Oruche, Downs, Holloway, Draucker & Aalsma, 2014). These statistics highlight the critical need for identification and implementation of effective child and family interventions for the mental health service system. Case management is a widely offered service within the children’s mental health system, but there is a scarcity of literature and research on models of case management and their effec- tiveness. This chapter introduces one model of case management, Strengths Model for Youth, and summarizes the current evidence on its effectiveness