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Background: This study aimed to evaluate the transition to adult care program instituted for liver transplant recipients (LTRs) at a large tertiary pediatric hospital in Melbourne, Australia. Evaluation included the change in a Global Assessment Measure (GAM) before and after the transition program, satisfaction with the program, and measures of transition success including rejection rates and attendance at appointments post‐transfer. We hypothesized that the introduction of our structured transition program would improve disease understanding, health system understanding, and self‐care. We also hypothesized that those who had undergone the transition program would have lower failure to attend rates and lower rates of rejection than historical controls. Methods: A LTR transition program was instituted at our service from 2013 to 2015. The program involved initial assessment of competencies with a Global Assessment Measure (GAM), followed by the introduction of a personalized goal setting program addressing issues identified in dedicated transition clinics. Assessment of competencies was compared between the commencement of the program and immediately prior to transfer. Patient satisfaction with the transition process was assessed at an interview 6–12 months after transfer to the adult service. Rejection rates and failure to attend rates were compared between the intervention group and a group of LTRs who did not receive the intervention. Results: Twenty‐eight LTRs participated in the study; 20 received the transition intervention and 8 served as controls. Within the intervention group, all domains of transition competency and reported anxiety regarding transferring had significantly improved at the conclusion of the intervention and all reported satisfaction with the transition program with most (81%) reporting readiness to transfer. There were no significant differences in rejection rates or failure to attend rates between those who did and did not receive the transition intervention. Conclusion: A longitudinal holistic transition program has the potential to positively impact the competencies and readiness of LTRs to successful transition and transfer to adult care. [ABSTRACT FROM AUTHOR]

Changing predator communities have been implicated in reduced survival of white‐tailed deer (Odocoileus virginianus) fawns. Few studies, however, have used field‐based age‐specific estimates for survival and fecundity to assess the relative importance of low fawn survival on population growth and harvest potential. We studied white‐tailed deer population dynamics on Tensas River National Wildlife Refuge (TRNWR) in Louisiana, USA, where the predator community included bobcats (Lynx rufus), coyotes (Canis latrans), and a restored population of Louisiana black bear (Ursus americanus luteolus). During 2013–2015, we radio‐collared and monitored 70 adult (≥2.5 yrs) and 21 yearling (1.5‐yr‐old) female deer. Annual survival averaged 0.815 (95% CI = 0.734–0.904) for adults and 0.857 (95% CI = 0.720–1.00) for yearlings. We combined these estimates with concurrently collected fawn survival estimates (0.27; 95% CI = 0.185–0.398) to model population trajectories and elasticities. We used estimates of nonhunting survival (annual survival estimated excluding harvest mortality) to project population growth (λ) relative to 4 levels of harvest (0, 10%, 20%, 30%). Finally, we investigated effects of reduced fawn survival on population growth under current management and with elimination of female harvest. Despite substantial fawn predation, the deer population on TRNWR was increasing (λ = 1.06) and could sustain additional female harvest; however, the population was expected to decline at 20% (λ = 0.98) and 30% (λ = 0.94) female harvest. With no female harvest, the population was projected to increase with observed (λ = 1.15) and reduced fawn survival (λ = 1.02), but the population could not sustain current female harvest (10%) if fawn survival declined (λ = 0.90). For all scenarios, adult female survival was the most elastic parameter. Given the importance of adult female survival, the relative predictability in response of adult survival to harvest management, and the difficulty in altering fawn survival, reducing female harvest is likely the most efficient approach to compensate for low fawn survival. On highly productive sites such as ours, reduction, but not necessarily elimination, of harvest can mitigate effects of low fawn survival on population growth. © 2020 The Wildlife Society. : White‐tailed deer population dynamics on Tensas River National Wildlife Refuge in Louisiana, USA, where the predator community included bobcats, coyotes, and a restored population of Louisiana black bear are characterized by high fecundity rates, low non‐harvest mortality for adults and yearlings, and low probability of survival for fawns. Given the importance of adult female survival to population growth, the relative predictability in response of adult survival to harvest management, and the difficulty in altering fawn survival, reducing female harvest is likely the most efficient approach to compensate for low fawn survival. [ABSTRACT FROM AUTHOR]

ABSTRACT Development workers employed by international nongovernmental organizations (NGOs) are commonly classified as national (local) or international (expatriate) staff members. The distinction is presumed to reflect the varieties of expertise required for the work and the workers' different biographies. I examine the experiences of Angolans working in an international democratization program to demonstrate how some professionals at the lowest tiers of international development NGOs engage in social practices that strategically emphasize or conceal certain skills, kinds of knowledge, or family circumstances to fulfill industry expectations of 'local staff.' Doing so allows them access to employment with international organizations and pursuit of a variety of personal and professional goals. These practices reinforce hierarchical inequalities within the development industry, however, limiting these workers' influence over programmatic action. I argue that professional distinctions among development workers are social achievements and instruments of strategic manipulation by individuals and NGOs rather than accurate reflections of work or workers. The case study provides insight into the institutional reproduction of hierarchical inequalities and the complexly social reasons why those who suffer their limitations may act in ways that reinforce, rather than resist, unequal social structures. [ABSTRACT FROM AUTHOR]

The article discusses the importance of a theology of solidarity as the foundation for economic and social relationships compared to the principles of individualism, profit, and wealth accumulation that drive the economic structures of human society. Topics include the role of the ethic of solidarity that flows from a theology of solidarity as a mode for first-world Christians for how to live faithfully, and sustainability and social justice as the bases of an ethic of solidarity.

An essay offering a feminist critique of the moral problems that characterize the dominant, neoliberal discourse on globalization and the ideology of neoclassical economics that support it is presented. It focuses attention on a moral assessment of the problems of poverty, wealth and ecology in the contemporary world. The author also comments that the values of social justice and sustainability are central to a healthy society.

The 20th anniversary of the National Firearms Agreement (NFA) offers lessons for mental health and public health. Along with similar international legislation, the NFA exemplifies how firearms regulation can prevent firearm mortality and injuries. The gun lobby claims that mental illness underpins gun violence and should be a key site for intervention. A modest but significant link exists between mental disorders and community violence. However, the vast majority of mentally ill individuals are not violent. Despite media portrayals of their dangerousness, they are more likely to be victims of violence and of suicide. Most violent individuals do not have mental illness, and most mass murderers do not have identifiable severe mental illness. Many have maladaptive personality configurations. Gun availability and gun ownership, not severe mental illness, determines most gun homicides. Following recent gun massacres in the United States, there have been calls for better resourcing of mental health services to help identify and respond to those at risk and to regulate firearms access. Screening mentally ill populations for violence risk is misguided. However, clinicians can play a key role in working with legal authorities to monitor and assist regulation of firearm access, especially among high risk populations. Clinician involvement must be complemented by wider gun control measures. The gun lobby's turning the firearms availability debate into a question about whether people with mental illness histories should access such weapons is a calculated appeal to prejudice. [ABSTRACT FROM AUTHOR]

The purpose of this review was to identify instruments designed to predict future child maltreatment and to evaluate their predictive accuracy. A number of electronic databases were searched to identify published studies. Only studies that had utilized a prospective methodology and tested at least one standardized instrument designed to identify families during the antenatal or postnatal periods who are at increased risk of maltreatment were included in the review. Eight studies were included that had prospectively tested a standardized instrument to predict child maltreatment during the antenatal or postnatal periods. Only six of the included studies followed up the entire sample, and of these only two did not provide an intervention for some or all of the high-risk group. While many of the included instruments obtained sensitivity and specificity above 80%, only two of the included instruments combined specificity over 80% with a positive predictive value above 25%. Currently available instruments have limited accuracy, suggesting that they should only be used to focus non-punitive interventions. These findings, in conjunction with other issues such as the stigma attached to the use of such instruments and difficulties in their application within a clinical and research context, suggest the need for a new approach to the identification of parents in need of higher levels of intervention. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Blockade of fatty acid oxidation in rat pups using 2-Mercaptoacetate (MA) produces increases in independent ingestion by 12 days of age. In the present experiments, the behavioral specificity of the effects of MA on ingestion were examined. In the first experiment, administration of MA to pups aged 9 and 12 days of age failed to increase intake of an oral infusion of a milk diet. In the second experiment, administration of MA did enhance intake of a milk diet in a short-term test of consuming from the floor of a test container and the level of gastric fill appeared to determine intake during the test. Finally, administration of MA did not affect intake of water in 9- or 12-day-old pups. These results suggest that MA produces increases in intake through specific effects on selective ingestive responses and not through nonspecific behavioral arousal. © 1999 John Wiley & Sons, Inc. Dev Psychobiol 34: 101–107, 1999 [ABSTRACT FROM AUTHOR]