Sex Panic and the Welfare State

2006 marked the tenth anniversary of the Personal Responsibility and Work Opportunity Reconciliation Act. The 1996 law was the culmination of decades of erosion in backing for basic provisions of the U.S. social safety net. The following reviews the political campaign that undermined thefoundationfor this vital component of the New Deal/Great Society income supports. A series of panics diminished approval for the welfare state, leading to the 1996 reform. Panic discourse increasingly accompanies policy debate. Examples of anti welfare, anti outsider panic discourses are explored

Between harm reduction, loss and wellness: on the occupational hazards of work

Those working in the fields of harm reduction, healthcare, and human services must cope with a range of stresses, including post traumatic stress and vicarious trauma. Pain and loss are just a part of the job. So is dealing with premature death as a result of HIV, hypertension, and even overdose. Faced with a range of challenges, some workers in the field even turn to self-medication. For some, it is about pleasure; for others it is about alleviating suffering. In recent years, several leaders in the AIDS and harm reduction fields have died ahead of their time. Some stopped taking their medications; others overdosed. Rather than weakness or pathology, French sociologist Emile Durkheim saw self-destructive behavior as a byproduct of social disorganization and isolation, as a way of contending with a breakdown of social bonds and alienation. There are any number of reasons why such behavior becomes part of work for those involved with battling the dueling epidemics of Hepatitis C, HIV, and related concerns. Forms of stress related to this work include secondary trauma, compassion fatigue, organizational conflict, burnout, complications of direct services, and lack of funding. Faced with day-to- day struggles over poverty, punitive welfare systems, drug use, the war on drugs, high risk behavior, structural violence, and illness, many in the field are left to wonder how to strive for wellness when taking on so much pain. For some, self-injury and self-medication are ways of responding. Building on ethnographic methods, this reflective analysis considers the stories of those who have suffered, as well as a few of the ways those in the field cope with harm and pain. The work considers the moral questions we face when we see our friends and colleagues suffer. It asks how we as practitioners strive to create a culture of wellness and support in the fields of harm reduction, healthcare, and human services. Through a brief review of losses and literature thereof, the essay considers models of harm reduction practice that emphasize health, pleasure and sustainability for practitioners

Harm Reduction Outreach Services and Engagement of Chemically Dependent Homeless People Living with HIV/AIDS: An Analysis of Service Utilization Data to Evaluate Program Theory

This study examines service utilization patterns among a socially vulnerable population of homeless people living with HIV/AIDS and who have a history of chemical dependence, as they are engaged through outreach services. CitiWide Harm Reduction collaborates with Montefiore Medical Center to connect homeless people with health care through harm reduction outreach and low threshold medical services. Analysis of two cohorts – individuals engaged through harm reduction outreach and individuals who “walk-in” to engage in services at CitiWide Harm Reduction’s drop-in center – assesses the program’s theory that outreach engagement is a mediating variable increasing service utilization. These results demonstrate that low-threshold harm reduction outreach, a brand of outreach designed to reduce barriers to services, does increase access to health care and related services for a socially vulnerable, traditionally “hard-to-reach,” population. Harm reduction outreach is a valuable intervention for increasing service utilization among this highly marginalized group

Human Sexuality as a Critical Subfield in Social Work

Human sexuality is of vital importance to social work practitioners, educators, and scholars. Yet historically, the profession’s leadership around it has waxed and waned, impacting practice. This article discusses the importance of human sexuality as a critical subfield within social work. It suggests that the mechanisms, namely textbooks, journals, and national conferences, for stimulating human sexuality social work scholarship are limited. The authors assert that the taboo of human sexuality limits the advancement of a cohesive professional discourse and contributes to the continued oppression of marginalized populations. Recommendations for providing better support for those who study, teach, and practice in the arena of human sexuality are offered

DIY Urbanism as an Environmental Justice Strategy: The Case Study of Time\u27s Up! 1987-2012

Time\u27s Up! is a New York environmental group which promotes nonpolluting transportation and sustainable solutions to an urban problems. Over the last twenty-five years, the group has taken a do-it-yourself approach to an environmental activism, bridging neighborhood, global justice, and occupy movements. With roots in the squatter movement in New York, Time\u27s Up! has built its own distinct brand of DIY urbanism to fight for community gardens, support group bike rides, and create sustainable approaches to an urban living. While the group makes use of a wide range of approaches to reclaim public space, direct action is its guiding principle. The group links social networks with alternative approaches to community building outside of institutional channels. The following considers Time\u27s Up! as a case study in environmental justice DIY urbanism

The Battle of Brooklyn: World City and Space of Neighborhoods.

Throughout Brooklyn, regular people are fighting off the negative dynamics of urban experience, including uneven development, speculative gentrification, displacement, and police brutality long seen in global cities. Yet, little of the global cities literature considers the ways local actors impact global forces shaping world cities. Instead, observers of globalization suggest local actors have been relegated the sidelines as passive spectators of larger social and economic forces. Many wonder, is there a space for agency in global cities? Can regular people shape the dynamics of life in cities? For many, the answer is clearly affirmative. Throughout the borough of Brooklyn, people are coping with the underside of globalization by creating viable alternatives. Could studying the Brooklyn experience offer some insight into efforts to cope with globalization? Throughout six case studies - on rezoning, eviction defense, a battle against a big box chain store, for a bike lane, a local business, and against police brutality- Brooklyn is viewed as a space which contends with the forces impacting globalization and uneven development in surprising and innovative ways

Monitoring Postoperative Opioid Use Following Simple Arthroscopic Meniscectomy: A Performance-Improvement Strategy for Prescribing Recommendations and Community Safety.

Background: Orthopaedic surgeons are confronted with a difficult dilemma: managing acute pain postoperatively and balancing the risk of prescription opioid use. To our knowledge, a prospective performance-improvement project providing opioid-prescription recommendations based on the actual amounts of usual and customary medication consumed following simple knee meniscectomy has not been described. Methods: One hundred and two patients undergoing arthroscopic knee meniscectomy prospectively recorded postoperative pain medications in a pain journal. Arthroscopic procedures were performed at 2 centers by 9 fellowship-trained senior surgeons. Various usual and customary prescribing protocols were observed, and the amount of medication consumed was recorded. Prescription and over-the-counter pain medication, quantity, frequency, and visual analog scale (VAS) pain scores were collected. Results: One hundred and two patients filled a prescription opioid medication and were included in the study. A total of 3,765 pills were prescribed, and a total of 573.5 were consumed. For the 102 patients who filled a prescription, the average time consuming opioid medication was 2 ± 2 days (range, 0 to 13 days) postoperatively. No cases of persistent use were recorded. Of the 102 patients who filled a prescription, 29.4% did not take any prescription opioids postoperatively. A total of 3,191.5 pills (or 22,183.75 morphine milligram equivalents [MME]) were unused and were potentially available to the community. Conclusions: Following simple knee arthroscopy, the amount of prescribed opioid medication exceeds the need for postoperative pain management. In general, 68% of patients require a maximum of 13 pills postoperatively for 6 days. Surgeons should adjust prescribing standards accordingly to limit the amount of prescription opioids available to the community. Furthermore, a comprehensive response to include increased patient screening and monitoring as well as opioid use and disposal education is recommended

Evolution of genomic sequence inhomogeneity at mid-range scales

<p>Abstract</p> <p>Background</p> <p>Mid-range inhomogeneity or MRI is the significant enrichment of particular nucleotides in genomic sequences extending from 30 up to several thousands of nucleotides. The best-known manifestation of MRI is CpG islands representing CG-rich regions. Recently it was demonstrated that MRI could be observed not only for G+C content but also for all other nucleotide pairings (e.g. A+G and G+T) as well as for individual bases. Various types of MRI regions are 4-20 times enriched in mammalian genomes compared to their occurrences in random models.</p> <p>Results</p> <p>This paper explores how different types of mutations change MRI regions. Human, chimpanzee and <it>Macaca mulatta </it>genomes were aligned to study the projected effects of substitutions and indels on human sequence evolution within both MRI regions and control regions of average nucleotide composition. Over 18.8 million fixed point substitutions, 3.9 million SNPs, and indels spanning 6.9 Mb were procured and evaluated in human. They include 1.8 Mb substitutions and 1.9 Mb indels within MRI regions. Ancestral and mutant (derived) alleles for substitutions have been determined. Substitutions were grouped according to their fixation within human populations: fixed substitutions (from the human-chimp-macaca alignment), major SNPs (> 80% mutant allele frequency within humans), medium SNPs (20% - 80% mutant allele frequency), minor SNPs (3% - 20%), and rare SNPs (<3%). Data on short (< 3 bp) and medium-length (3 - 50 bp) insertions and deletions within MRI regions and appropriate control regions were analyzed for the effect of indels on the expansion or diminution of such regions as well as on changing nucleotide composition.</p> <p>Conclusion</p> <p>MRI regions have comparable levels of de novo mutations to the control genomic sequences with average base composition. De novo substitutions rapidly erode MRI regions, bringing their nucleotide composition toward genome-average levels. However, those substitutions that favor the maintenance of MRI properties have a higher chance to spread through the entire population. Indels have a clear tendency to maintain MRI features yet they have a smaller impact than substitutions. All in all, the observed fixation bias for mutations helps to preserve MRI regions during evolution.</p