Capital Punishment of Kids: When Courts Permit Parents to Act on Their Religious Beliefs at the Expense of Their Children\u27s Lives

Criminal liability of parents who treat their children\u27s illnesses through spiritual means or prayer alone is the subject of increasing debate. When children die as a result of their parents\u27 religious practices, prosecutions for crimes such as felony child endangerment, manslaughter, and murder may follow. Most states have codified some type of religious accommodation statute which provides a criminal liability exemption for parents who engage in spiritual healing or prayer treatment for their sick children instead of seeking traditional medical assistance. The scope, purpose, and language of these statutes, however, vary. Even when statutes appear to be similar in content, courts have disagreed on the correct interpretation and applicability of the liability exemptions. A primary problem facing courts in these cases is how to interpret the language in the statute and whether two or more statutes involved in a case should be construed together in defining criminal behavior. Moreover, defendants in accommodation statute cases have forced courts to decide several constitutional issues dealing with the Establishment Clause, the Due Process Clause, the Equal Protection Clause, and the First Amendment freedom of religion. While the other concerns implicated by these statutes are significant, this Note will focus on the issues of statutory construction, freedom of religion, and the notice requirement of due process. Part II discusses the legal background of religion\u27s role in the law. Part III describes two cases, one from California and the other from Florida, that illustrate the debate over the conviction of parents who rely on similar prayer exemption provisions as criminal defenses. Part IV analyzes the reasoning utilized by both courts in reaching their holdings and examines the ramifications of each holding. Part V concludes that religious accommodation statutes should not protect parents from criminal prosecutions for the death of or serious bodily harm to their children

A Survey of Counselors in Private Practice

A survey of members in the American Mental Health Counselors Association conducted to assess certain demographic data and counselor participation in private practice conducted in 1980 by William J. Weikel, Richard W. Daniel and Janet Anderson

Pattern languages in HCI: A critical review

This article presents a critical review of patterns and pattern languages in human-computer interaction (HCI). In recent years, patterns and pattern languages have received considerable attention in HCI for their potential as a means for developing and communicating information and knowledge to support good design. This review examines the background to patterns and pattern languages in HCI, and seeks to locate pattern languages in relation to other approaches to interaction design. The review explores four key issues: What is a pattern? What is a pattern language? How are patterns and pattern languages used? and How are values reflected in the pattern-based approach to design? Following on from the review, a future research agenda is proposed for patterns and pattern languages in HCI

Resilience engineering as a quality improvement method in healthcare

Current approaches to quality improvement rely on the identification of past problems through incident reporting and audits or the use of Lean principles to eliminate waste, to identify how to improve quality. In contrast, Resilience Engineering (RE) is based on insights from complexity science, and quality results from clinicians’ ability to adapt safely to difficult situations, such as a surge in patient numbers, missing equipment or difficult unforeseen physiological problems. Progress in applying these insights to improve quality has been slow, despite the theoretical developments. In this chapter we describe a study in the Emergency Department of a large hospital in which we used RE principles to identify opportunities for quality improvement interventions. In depth observational fieldwork and interviews with clinicians were used to gather data about the key challenges faced, the misalignments between demand and capacity, adaptations that were required, and the four resilience abilities: responding, monitoring, anticipating and learning. Data were transcribed and used to write extended resilience narratives describing the work system. The narratives were analysed thematically using a combined deductive/inductive approach. A structured process was then used to identify potential interventions to improve quality. We describe one intervention to improve monitoring of patient flow and organisational learning about patient flow interventions. The approach we describe is challenging and requires close collaboration with clinicians to ensure accurate results. We found that using RE principles to improve quality is feasible and results in a focus on strengthening processes and supporting the challenges that clinicians face in their daily work

Patient Communication Training Skills for High School Health and Wellness Classes

poster abstractPhysicians are now trained in interpersonal skills intended to improve clinical outcomes and patient satisfaction while reducing provider burnout and decreasing the likelihood of litigation. However, shared decision-making by nature necessitates the need for patient communication training as well. Indiana requires a Health and Wellness class for high school graduation; this is the ideal time to reach young people - before they become adult patients navigating their own healthcare. Funded by an IU Heath Values Grant for Education, this project utilizes cutting edge technology in the form of a multimedia module that can be integrated into existing Health and Wellness classes. The award-winning Herron High School, ranked in the top 5% of schools nationwide by Newsweek, U.S. News and the Washington Post, has agreed to explore the application as the pilot school for this project. The interactive web-based module is designed to reach the student population as four learning units following the successful PACE adult patient training design by Ohio State health communication scholar, Dr. Don Cegala. Patient/provider exchanges filmed at University Hospital illustrate modeling of the typical, passive mode of communication followed by the effective mode of communication using the PACE model of patient training. The Medical Communication Competence Scale is applied as a pretest/posttest for check for attitudinal changes and a series of open feedback questions are available for student responses. This project is a work in progress and data analysis is under review

Establishing Doctoral Programs in Electrical Engineering, Materials Science and Engineering, and Computing in an Emerging Research Institution: Lessons Learned and Best Practices

Over the past decade, three doctoral programs have been launched at Boise State University. The first doctoral program established was in Electrical and Computer Engineering, selected because of the need for a trained workforce in the region. The other two doctoral programs, Materials Science and Engineering, and Computing, were from the start designed as interdisciplinary degree programs. That is, they were designed for the participation of not just program faculty within the division, but for the participation of program faculty with related research interests in other departments at the university. This paper presents the steps taken to launch the programs, lessons learned in initiating and administering the programs, best practices undertaken, and challenges faced by the emerging doctoral degree programs

A randomized, placebo-controlled trial of late Na current inhibition (ranolazine) in coronary microvascular dysfunction (CMD): impact on angina and myocardial perfusion reserve.

AimsThe mechanistic basis of the symptoms and signs of myocardial ischaemia in patients without obstructive coronary artery disease (CAD) and evidence of coronary microvascular dysfunction (CMD) is unclear. The aim of this study was to mechanistically test short-term late sodium current inhibition (ranolazine) in such subjects on angina, myocardial perfusion reserve index, and diastolic filling.Materials and resultsRandomized, double-blind, placebo-controlled, crossover, mechanistic trial in subjects with evidence of CMD [invasive coronary reactivity testing or non-invasive cardiac magnetic resonance imaging myocardial perfusion reserve index (MPRI)]. Short-term oral ranolazine 500-1000 mg twice daily for 2 weeks vs. placebo. Angina measured by Seattle Angina Questionnaire (SAQ) and SAQ-7 (co-primaries), diary angina (secondary), stress MPRI, diastolic filling, quality of life (QoL). Of 128 (96% women) subjects, no treatment differences in the outcomes were observed. Peak heart rate was lower during pharmacological stress during ranolazine (-3.55 b.p.m., P < 0.001). The change in SAQ-7 directly correlated with the change in MPRI (correlation 0.25, P = 0.005). The change in MPRI predicted the change in SAQ QoL, adjusted for body mass index (BMI), prior myocardial infarction, and site (P = 0.0032). Low coronary flow reserve (CFR <2.5) subjects improved MPRI (P < 0.0137), SAQ angina frequency (P = 0.027), and SAQ-7 (P = 0.041).ConclusionsIn this mechanistic trial among symptomatic subjects, no obstructive CAD, short-term late sodium current inhibition was not generally effective for SAQ angina. Angina and myocardial perfusion reserve changes were related, supporting the notion that strategies to improve ischaemia should be tested in these subjects.Trial registrationclinicaltrials.gov Identifier: NCT01342029

Patients’ use of information about medicine side effects in relation to experiences of suspected adverse drug reactions

Background Adverse drug reactions (ADRs) are common, and information about medicines is increasingly widely available to the public. However, relatively little work has explored how people use medicines information to help them assess symptoms that may be suspected ADRs. Objective Our objective was to determine how patients use patient information leaflets (PILs) or other medicines information sources and whether information use differs depending on experiences of suspected ADRs. Method This was a cross-sectional survey conducted in six National Health Service (NHS) hospitals in North West England involving medical in-patients taking at least two regular medicines prior to admission. The survey was administered via a questionnaire and covered use of the PIL and other medicines information sources, perceived knowledge about medicines risks/ADRs, experiences of suspected ADRs, plus demographic information. Results Of the 1,218 respondents to the survey, 18.8 % never read the PIL, whilst 6.5 % only do so if something unexpected happens. Educational level was related to perceived knowledge about medicines risks, but not to reading the PIL or seeking further information about medicines risks. Over half the respondents (56.0 %) never sought more information about possible side effects of medicines. A total of 57.2 % claimed they had experienced a suspected ADR. Of these 85.9 % were either very sure or fairly sure this was a reaction to a medicine. Over half of those experiencing a suspected ADR (53.8 %) had read the PIL, of whom 36.2 % did so before the suspected ADR occurred, the remainder afterwards. Reading the PIL helped 84.8 % of these respondents to decide they had experienced an ADR. Educational level, general knowledge of medicines risks and number of regular medicines used all increased the likelihood of experiencing an ADR. Conclusion More patients should be encouraged to read the PIL supplied with medicines. The results support the view that most patients feel knowledgeable about medicines risks and suspected ADRs and value information about side effects, but that reading about side effects in PILs or other medicines information sources does not lead to experiences of suspected ADRs

Some considerations concerning the challenge of incorporating social variables into epidemiological models of infectious disease transmission

Incorporation of ‘social’ variables into epidemiological models remains a challenge. Too much detail and models cease to be useful; too little and the very notion of infection —a highly social process in human populations—may be considered with little reference to the social. The French sociologist Emile Durkheim proposed that the scientific study of society required identification and study of ‘social currents.’ Such ‘currents’ are what we might today describe as ‘emergent properties,’ specifiable variables appertaining to individuals and groups, which represent the perspectives of social actors as they experience the environment in which they live their lives. Here we review the ways in which one particular emergent property, hope, relevant to a range of epidemiological situations, might be used in epidemiological modelling of infectious diseases in human populations. We also indicate how such an approach might be extended to include a range of other potential emergent properties to repre