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Aims and objectives This study aimed to understand how licenced practical nurses perceive their work environments across different work settings and to analyse the association between these nurses’ perceptions of their work environments and their intentions to stay employed at their current nursing unit. Design A cross‐sectional descriptive survey was conducted with Licensed Practical Nurses in Alberta, Canada. Methods The study population consisted of 598 licenced practical nurses. Survey measures included demographic information, the Perceived Work Environment‐Nursing Work Index, and an intention to stay scale. Descriptive statistics were calculated and mean scores for perceptions about the work environment were compared by work setting. The associations between perceived work environment and intention to stay were analysed using linear regression. Results Overall, licenced practical nurses rated their work environment as mixed, with statistically significantly lower scores in acute care settings. Nurse manager ability and adequate staffing and resources were the highest contributing variables.

Aims and Objectives To explore clinical nurses’ process of coping during COVID‐19 and develop a grounded theory that can be used by leaders to support clinical nurses during a disaster. Background The COVID‐19 pandemic has provoked widespread disruption to clinical nurses’ work. It is important to understand clinical nurses’ processes of coping during disasters to support the nursing workforce during events such as global pandemics. Design We employed the Corbin and Strauss variant of grounded theory methodology, informed by symbolic interactionism, and applied the EQUATOR guidelines for qualitative research publication (COREQ). Methods Data collection entailed semi‐structured interviews with experienced clinical nurses (n =20) across diverse settings. We analysed data by identifying key points in the nurses’ coping processes inductively building concepts around these points. Results The predictor of nurses’ outcomes in this grounded theory was their confidence in their ability to cope during the pandemic. When nurses lacked confidence, they experienced working in the context of acute COVID—a state of chaos and anxiety, with negative consequences for nurses. However, when nurses were confident in their abilities to cope with the pandemic, they experienced working in the context of chronic COVID, a calmer state of acceptance. There were many workplace factors that influenced nurses’ confidence, including adequacy of personal protective equipment, clear information and guidance, supportive leadership, teamwork and adequate staffing. Conclusions Understanding clinical nurses’ experience of coping during COVID‐19 is essential to maintain the nursing workforce during similar disasters. Relevance to clinical practice Nurse leaders can target areas that support nurses’ confidence, such as adequate PPE and staffing. In turn, increased confidence enables clinical nurses to cope during disasters such as a global pandemic.

Problem: Guillain-Barre syndrome (GBS) is an immune-mediated polyradiculoneuropathy, with an incidence of 1-2/100,000 per year and variable severity. Due to the rarity of this condition there is limited evidence exploring the experiences of patients with GBS. The aim of this study was to review patients’ experiences and perceptions of GBS, by conducting a systematic review and thematic meta-synthesis of qualitative studies of patients’ experiences of GBS. Approach: We searched twelve electronic databases, supplemented with internet searches and forward and backward citation tracking from the included studies and review articles. Data were synthesised thematically following the Thomas and Harden approach. The CASP Qualitative Checklist was used to assess risk of bias in included studies. Findings: Our search strategy identified a total of 4,204 citations and after removing duplicates and excluding citations based on title and abstract, and full-text screening, five studies were included in the review and meta-synthesis; all included studies were considered of acceptable quality. Through an iterative approach, we developed six analytical themes. The first theme discusses the patients’ initial symptoms, how they struggled to receive a diagnosis, their feelings of uncertainty, and how hope of recovery was their main motivation forward. The second theme summarises the effects of GBS on all aspects of patients’ lives, including their ongoing physical difficulties (e.g. pain and fatigue), their psychological well-being (e.g. anxiety and fear), their family and social lives, as well as their ability to work. The third theme describes how participants were not satisfied with the support they received from healthcare services and that this was considered a key barrier preventing their recovery from GBS. In contrast, the fourth theme discussed how some participants had positive feelings towards the healthcare and the support they received from family, friends and peers. The final two themes discuss the participants’ path to recovery through achieving milestones and slowly accepting their situation. Their desire to go back to their pre-GBS selves, and the importance of re-valuating life are also presented.Despite the variety of experiences, it was evident that being diagnosed with and surviving GBS was a life-changing experience for all participants. Consequences: Exploring this literature has enabled us to identify how patients may need extra support to cope better with their recovery and also identify ways that healthcare professionals and services can help facilitate further such a recovery. Funding acknowledgement: The study was supported by a grant from the GAIN (Guillain-Barre & Associated Inflammatory Neuropathies) charity.

Although in Canada, hearing screening and early intervention are presented as a health need, we question whether young deaf and hard of hearing children's access to language is adequately supported by public health and children's services. The Ontario Infant Hearing Program has the stated mandate of supporting the language development of deaf and hard of hearing infants and young children. However, this program presents parents with early intervention service options involving either spoken or signed language, but not both together. This policy effectively restricts access to sign language learning for a majority of Ontario's deaf children. Consequently, some deaf children suffer language deprivation and its deleterious effects on cognition and emotional development. In support of our arguments, we refer to Article 25 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which Canada has signed and ratified. The CRPD supports recognition of deaf children's right to sign language as a health need because language deprivation occurs in many children who are not offered sign language, and this is a permanent impairment imposed on top of hearing loss. We conclude that in Canada, health services for deaf children do not align with accessibility and human rights legislation, thus creating a policy gap that leaves deaf children vulnerable to additional impairment.

Summary This article’s premise is that the practice of representatives of international organizations has something important to tell us about what it means to ‘do desecuritization’. The analysis provides a qualitative process-tracing of diplomacy by the Organization for Security and Co-operation in Europe’s (OSCE’s) High Commissioner on National Minorities (HCNM). It finds that ‘new diplomats’ can ‘do desecuritization’ differently. By rearticulating norms, as well as negotiating interests, the HCNM is able to escape the constraints imposed by security grammar and begin to transform the friend–enemy distinction within states. ‘New diplomats’ like the HCNM are capable of initiating such fundamental changes within states because their non-state platforms and institutional cultures transcend traditional international dichotomies of ‘us’ and ‘them’. These findings add nuance to our understanding of desecuritization as practice and suggest a novel methodological approach for studying desecuritization empirically.

With the introduction in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) of a hybrid system of personality disorder assessment, the ability to assess patients' traits, as well as their level of personality functioning, has become increasingly important. To assess this criterion, the DSM-5 Levels of Personality Functioning Questionnaire (DLOPFQ) was developed. The DLOPFQ assesses individuals' self-impairments and other impairments in several domains (self-direction, identity, empathy, and intimacy) and across 2 contexts (work/school and relationships). A sample of 140 psychiatric and medical outpatients was administered the DLOPFQ and several other measures to assess its reliability and construct, incremental, and discriminant validity. The internal consistency and convergence with validation measures yielded generally meaningful and expected results. Several DLOPFQ scales and subscales were significantly correlated with measures of DSM-5 trait domains and levels of personality functioning. DLOPFQ scales also correlated with self-reported ratings of overdependence, detachment, healthy dependency, and overall mental health and well-being. The DLOPFQ also predicted interpersonal and general functioning beyond DSM-5 trait domains. These results support the reliability and validity of the DLOPFQ, which appears to be suitable for clinical use and warrants ongoing study. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

While the malignant self-regard construct and a corresponding questionnaire, the Malignant Self-Regard Questionnaire (MSRQ; Huprich, 2011) have been empirically evaluated in several non-clinical samples, it has yet to be evaluated in a clinical population. In this study, 139 outpatients in the Departments of Psychiatry and Behavioral Sciences (n = 83) and Internal Medicine (n = 57) were administered the MSRQ and a number other measures to assess its construct and incremental validity. The MSRQ was internally consistent in both samples, and was positively correlated with four dimensions of levels of personality functioning, DSM-5 personality trait domains, overdependence, detachment, insecure attachment, and general perceptions of physical and mental well-being. Furthermore, the MSRQ incrementally predicated variance in levels of personality functioning, interpersonal dependency, and general perceptions of physical and mental well-being above and beyond DSM-5 traits and (where appropriate) levels of personality functioning. These findings converge with studies of the MSRQ in nonclinical samples and support the clinical utility and validity of the MSRQ for further use.

“What will you do to support nursing research?” I asked. “Well, care is interprofessional, so I don’t think we really need disciplinary research,” they replied. This was the first time I had heard this sentiment expressed directly by a physician, but I had brushed up against it before. I was referred to as coming from the “school” of nursing, rather than the faculty. My conference presentations have been greeted with physician jokes of “so that’s what nurses do,” followed by laughter, or sarcastic questions about how nurses playing sudoku during work time fit into their roles. There are also formalised examples of physicians dismissing nursing. Last year the editor in chief of a medical journal had to apologise1 after a peer reviewed article provided comebacks for doctors who were mistaken for …

Purpose The purpose of this conceptual paper is to make the case for the value of fostering collaborative sensemaking in responding to literature. Drawing on examples of classroom interactions in 6th-, 8th-, 11th- and 12th-grade classrooms, it proposes methods for teachers to foster collaborative sensemaking. Design/methodology/approach Drawing on theories of “participatory sensemaking” (Fuchs and De Jaegher, 2009), transactional literary response (Rosenblatt, 1994) and “comprehension-as-sensemaking” pedagogy (Aukerman, 2013), this paper conceptualizes collaborative sensemaking to illustrate how teachers foster making sense of texts through sharing responses based on lived-world experiences, understanding the use of literary techniques and understanding events in students’ own lives. Findings Given that this is not an empirical study, there are no findings. The discussion of students’ sensemaking practices in responding to classroom texts, suggests the importance of teachers creating open-ended response events in which students collaboratively support each other in making sense of characters’ actions and events, as opposed to having to conform to teachers’ predetermined agendas. Practical implications Analysis of the classroom discussions suggests the importance of building students’ trust in the process of sensemaking itself, fostering adoption of alternative perspectives as central to sensemaking and using activities for students’ translating or rewriting events in texts to co-create texts with authors. Originality/value This paper explores the importance of teachers engaging students in open-ended, sensemaking response events based on attending to “in-between,” dialogic meanings through sharing emotions, alternative perspectives and related experiences to enhance students’ engagement in responding to literature.

This chapter addresses the following question: why should ethnonational minorities be a subject of international relations when this field is concerned, in the main, with states and not groups or individuals within a state’s domestic jurisdiction? The reason for international interest is that in the contemporary practice of self-determination, there is often little fit between international boundaries and ethnonational identities. Self-determination is a highly indeterminate concept in the international system. Continued demands for ethnonational self-determination on the part of minorities became a source of international rivalry and discontent within the interwar state system. Historically, the existence of minorities in an international system that purports to be based upon a norm of self-determination has evoked three international responses. These are: an individual human rights regime; the physical elimination of ethnonational minorities either by adjusting peoples to match borders or borders to match peoples; and regime of ethnonational minority rights that falls short of sovereign statehood.

Background Many critical care nurses experience burnout; however, resilience shows promise as a potential solution to burnout. This study was conducted to better understand nurse burnout and resilience in response to workplace adversity in critical care. Design A grounded theory investigation, using the Corbin and Strauss methodology. Participants engaged in qualitative, open-ended interviews about burnout and resilience. Setting A multi-site, urban, teaching hospital in Canada. Participants 11 female critical care nurses, with 1–30+ years of critical care experience. Findings Burnout and resilience can be understood as indicators in a process of responding to workplace adversity. Workplace adversity can take many forms and has a negative impact on nurses. Nurses must be aware of this impact to take action. The process of Managing Exposure is how nurses address workplace adversity, using variety of techniques: protecting, processing, decontaminating, and distancing. The indicators of this process for nurses are thriving, resilience, survival and burnout. Organisational policies can impact on this process. Conclusions Resilience and burnout are connected, as indicators of the same process for critical care nurses. Nurse leaders can intervene throughout this process to reduce workplace adversity and support resilience among nurses.

Objective Prescription drug misuse is an important public health problem in the U.S., particularly among adolescents and young adults. Few studies have examined factors contributing to initiation into prescription drug misuse, including sexual orientation and childhood abuse and neglect. The purpose of the present study is to investigate the relationship between initiation into the misuse of prescription drugs (opioids, tranquilizers, and stimulants), sexual identity, and individual and family determinants. Method Results are based upon data from a cross-sectional survey of 596 youth (polydrug users, homeless youth, and injection drug users) aged 16 to 25 who reported current prescription drug misuse. Participants were recruited in Los Angeles and New York City between 2009 and 2011. We compared initiation behaviors between sexual minority and heterosexual youth and examined factors modifying the relationship between sexual identity and earlier initiation into prescription drug misuse. Results Sexual minority youth were more likely to report histories of initiation into misuse of prescription opioids and tranquilizers. Further, they were more likely to report various types of childhood abuse than heterosexual youth. However, multivariate analyses indicated that age of first prescribed drug was the most significant factor associated with initiation into misuse of all three categories of prescription drugs. Conclusions The correlates of initiation into prescription drug misuse are multidimensional and offer opportunities for further research. Identifying additional factors contributing to initiation into prescription drug misuse is essential towards developing interventions that may reduce future drug use among young adults.

Background Prescription opioids are the most frequently misused class of prescription drugs amongst young adults. Initiation into prescription opioid misuse is an important public health concern since opioids are increasingly associated with drug dependence and fatal overdose. Descriptive data about initiation into prescription opioid misuse amongst young injection drug users (IDUs) are scarce. Methods An exploratory qualitative study was undertaken to describe patterns of initiation into prescription opioid misuse amongst IDUs aged 16–25 years. Those young IDUs who had misused a prescription drug at least three times in the past three months were recruited during 2008 and 2009 in Los Angeles ( n =25) and New York ( n =25). Informed by an ethno-epidemiological approach, descriptive data from a semi-structured interview guide were analysed both quantitatively and qualitatively. Results Initiation into prescription opioid misuse was facilitated by easy access to opioids via participant's own prescription, family, or friends, and occurred earlier than misuse of other illicit drugs, such as heroin. Nearly all transitioned into sniffing opioids, most injected opioids, and many initiated injection drug use with an opioid. Motives for transitions to sniffing and injecting opioids included obtaining a more potent high and/or substituting for heroin; access to multiple sources of opioids was common amongst those who progressed to sniffing and injecting opioids. Conclusion Prescription opioid misuse was a key feature of trajectories into injection drug use and/or heroin use amongst this sample of young IDUs. A new pattern of drug use may be emerging whereby IDUs initiate prescription opioid misuse before using heroin.

Background Ketamine is a dissociative anaesthetic that became increasingly popular in the club and rave scene in the 1980s and 1990s. Reports surfaced in the late 1990s indicating that ketamine was being injected in several U.S. cities by young injection drug users (IDUs). Since all studies on ketamine injection were cross-sectional, a longitudinal study was undertaken in 2005 to determine: characteristics of young IDUs who continue to inject ketamine; frequency of ketamine injection over an extended time period; risks associated with ongoing ketamine injection; and environmental factors that impact patterns of ketamine use. Methods Young IDUs aged 16–29 with a history of injecting ketamine ( n =101) were recruited from public locations in Los Angeles and followed during a 2-year longitudinal study. A semi-structured instrument captured quantitative and qualitative data on patterns of ketamine injection and other drug use. A statistical model sorted IDUs who completed three or more interviews ( n =66) into three groups based upon patterns of ketamine injection at baseline and follow-up. Qualitative analysis focused on detailed case studies within each group. Results IDUs recruited at baseline were typically in their early 20s, male, heterosexual, white, and homeless. Longitudinal injection trajectories included: "Moderates," who injected ketamine several times per year ( n =5); "Occasionals," who injected ketamine approximately once per year ( n =21); and "Abstainers," who did not inject any ketamine during follow-up ( n =40). Findings suggest that ketamine is infrequently injected compared to other drugs such as heroin, cocaine, and methamphetamine. Most IDUs who begin injecting ketamine will stop or curb use due to: negative or ambivalent experiences associated with ketamine; an inability to find the drug due to declining supply; or maturing out of injecting drugs more generally. Conclusion Reducing ketamine injection among young IDUs may best be accomplished by targeting particular groups of IDUs identified in this study, such as homeless youth and homeless travellers.

This article describes how the drug type injected at the first injection event is related to characteristics of the initiate, risk behaviors at initiation, and future drug-using trajectories. A diverse sample (n=222) of young injection drug users (IDUs) were recruited from public settings in New York, New Orleans, and Los Angeles during 2004 and 2005. The sample was between 16 and 29 years old, and had injected ketamine at least once in the preceding two years. Interview data was analyzed both quantitatively and qualitatively. Young IDUs initiated with four primary drug types: heroin (48.6%), methamphetamine (20.3%), ketamine (17.1%), and cocaine (14%). Several variables evidenced statistically significant relationships with drug type: age at injection initiation, level of education, region of initiation, setting, mode of administration, patterns of self-injection, number of drugs ever injected, current housing status, and their hepatitis C virus (HCV) status. Qualitative analyses revealed that rationale for injection initiation and subjective experiences at first injection differed by drug type.

Diverse forms of drug use are an emerging theme within research on young people and substance use. This manuscript, based on a three city study of health risks amongst young injection drug users, explores multiple drug use and polydrug use amongst a subset of homeless youth referred to as "travelers." In particular, we outline characteristics of homeless traveler youths and the various ways in which they practiced multiple drug use and polydrug use. From here, we discuss some theoretical and public health implications of multiple drug use and polydrug use amongst this particular population.

Ketamine, a dissociative anesthetic, has emerged as an increasingly common drug among subgroups of young injection drug users (IDUs) in cities across the United States. In-depth qualitative interviews were conducted with 213 young IDUs aged 16–28 years recruited in New York, New Orleans, and Los Angeles between 2004 and 2006. While some initiated injection drug use with ketamine, the drug was more frequently injected by IDUs with extensive polydrug using histories. IDUs initiating with ketamine commonly self-injected via an intramuscular mode of administration. The injection group provided crucial knowledge and material resources that enabled the injection event to occur, including ketamine, syringes, and injection skills. Injection paraphernalia was commonly shared during the first injection of ketamine, particularly vials of pharmaceutically-packaged liquid ketamine. Injection events infrequently occurred in a rave or club and more typically in a private home, which challenges ketamine’s designation as a ‘club’ drug. The first injection of ketamine was a noteworthy event since it introduced a novel drug or new mode of administration to be further explored by some, or exposed others to a drug to be avoided in the future. Risk reduction messages directed towards young IDUs should be expanded to include ketamine.

Consultation of the views of the public and interested groups on the intentions and outcomes of government and public sector institutions is now an integral feature of the policy making process. What, however, is less certain is the value and effectiveness of these consultations both from the perspective of the policy-maker and those who are ‘consulted’. This paper therefore seeks to examine the issues surrounding the consultation process through a project the Community Operational Research Unit (CORU) undertook, which reviewed the effectiveness of consultation between Access/disability groups and the public sector at a local and national level. The paper will equally reflect on the project's community research path beginning in very localised ‘roots’ in one participants experiences of consultation, leading to local and national surveys and finally to presentation of the findings to the All Party Disability Group (APDG) at Westminster.

Health inequalities and offending are issues that have raised considerable interest fmm policy makers, practitioners and the research communi~ as they seek to understand the causes and the potential solutions to their redress. A research 'gap' nevertheless exists in that whilst successive reports have identified vulnerable groups who are most likely to offend and have 'poor' health outcomes, there is limited 'field' research amongst these groups traditionally considered 'hard to reach'. As.this paper explores in 2003 the Community Operational Research Unit (CORUj was invited to evaluate a Healthy Living Centre (HLC) within Lincolnshire Probation and this provided an exceptional opportunity to examine the problems through a sustained 'engaged' research project. What became evident as the HLC and the research emerged were the challenges and rewards of community operational research as much as the issues rhat were intensively explored.

This paper argues for a change of thinking about the ‘ideal body’ in relation to ballet as a dance form and how it is studied. It distinguishes between spectator and practitioner perspectives on ballet, and draws on the practice of established dance artists and that of the author to write about the first‐person experience—from the inside out. Using a balletic concept, en dehors/en dedans, as a metaphor, the discussion moves from looking at the outside product of the ballet inwards to look at the inside processes or practice. The impact of the spectator perspective on the characterization of practice is considered, raising questions about the construction of binaries such as free/rule bound and the perception of the body and form as fixed. A case is made for ballet study as a somatic practice, and how engaging the first‐person experience and perspective on the body allows the individual dancer to develop as both artist and technician.

1. Introduction Jennifer Jackson and Lina Molokotos-Liederman Part I: Theoretical framework and methodological considerations 2. A new model of boundary complexity Richard Jenkins 3. 'Boundary', 'Border', 'Limit' in the Human Sciences: Towards a Conceptual History Jean Terrier 4. Modernity, globalization and nationalism: The age of frenzied boundary-building Daniele Conversi 5. Ethnic boundaries: A critical rationalist perspective Michael Banton Part II: Case Studies 6. Boundaries and Belonging: Dominant Ethnicity and the Place of the Nation in a Global Era Michael Skey 7. A' the Bairns o' Adam? The Ethnic Boundaries of Scottish National Identity Michael Rosie 8. Ethnicity and Boundaries in Jewish Nationalism Yitzhak Conforti Part III: Comparative Perspectives 9. The migration of frontiers. Ethno-national conflicts and contested cities Wendy Pullan 10. Nationalizing States and Ethno-national Boundaries: A Comparative Perspective on Soviet Successor States Rogers Brubaker 11.Conflict Management in Divided Societies: The Many Uses of Territorial Self-Governance Stefan Wolff 12. Concluding Remarks Jennifer Jackson and Lina Molokotos-Liederman

Background. Prescription opioids are the most frequently misused class of prescription drug among young adults aged 18–25, yet trajectories of opioid misuse and escalation are understudied. We sought to model opioid misuse patterns and relationships between opioid misuse, sociodemographic factors, and other substance uses.Methods. Participants were 575 young adults age 16–25 who had misused opioids in the last 90 days. Latent class analysis was performed with models based on years of misuse, recency of misuse, and alternate modes of administration within the past 12 months, 3 months, and 30 days.Results. Four latent classes emerged that were differentially associated with heroin, cocaine, and methamphetamine use, tranquilizer misuse, daily opioid misuse, and opioid withdrawal. Alternate modes of administering opioids were associated with increased risk for these outcomes. Sociodemographic factors, homelessness, prescription history, and history of parental drug use were significantly associated with riskier opioid misuse trajectories.Conclusion. Young adults who reported more debilitating experiences as children and adolescents misused opioids longer and engaged in higher risk alternate modes of administering opioids. Data on decisions both to use and to alter a drug’s form can be combined to describe patterns of misuse over time and predict important risk behaviors.

National minorities are collectivities who possess that trait which is the current normative underpinning of states, namely nationhood, and yet for practical purposes cannot enjoy outright political independence. Because national minorities bear these normatively significant characteristics they may be deemed to have legitimate international claims to certain special rights even if these fall short of statehood. Yet although this rationale may be logically sound and morally justified, pursuing it nevertheless raises serious problems with regard to state sovereignty.

It could not have been predicted when the first Sub-Commission [on the Prevention of Discrimination and Protection of Minorities] resolution on population transfer [or ethnic cleansing] was adopted in 1990 that this form of human rights abuse would become so central to conflicts and pressing political issues of which the international community is now seized. A.S. AI-Khasawneh and R. Hatano UN Special Rapporteurs, 19932

The 1990s debate on minority rights clearly indicates that minority issues are among the most controversial subjects of international relations. Questions concerning national minorities gained new prominence in international relations, especially in East Central Europe, following the end of the Cold War. Between 1990 and 1995 the formulation of international standards regulating state conduct towards national minorities was a priority for European organisations. This standard setting episode raises several important questions. Why did national minorities reappear on the international agenda after 1989? How were they responded to? Why did state sovereignty continue to take precedence over minority rights?

Sovereign insiders and minority outsidersThe ‘problem of minorities’, with its numerous implications for both international theory and practice, has been a significant issue in international society for centuries. It has constituted an ongoing friction between states, a pretext for separatism, irredentism and intervention, and a direct and indirect cause of local and general wars.Among the best works which examine various aspects of the ‘problem of minorities’ are the following: I. Bagley, General Principles and Problems in the International Protection of Minorities (Geneva, 1950); I. Claude, National Minorities: An International Problem (Cambridge, MA, 1955); G. Gotlieb, Nation Against State (New York, 1993); W. Kymlicka, Multicultural Citizenship (Oxford, 1995); J. Laponce, The Protection of Minorities (Berkeley, CA, 1960); C. Macartney, Nation States and National Minorities (London, 1934); J. Mayall, Nationalism and International Society (Cambridge, 1990); H. Miall (ed.), Minority Rights in Europe (London, 1994); D. Moynihan, Pandaemonium; Ethnicity in International Politics (Oxford, 1993); and P. Thornberry, International Law and the Rights of Minorities (Oxford, 1991). Why?

Young female injection drug users (IDUs) are at risk for HIV/HCV, and initiating the use of a new drug may confer additional and unexpected risks. While gender differences in the social context of injection drug use have been identified, it is unknown whether those differences persist during the initiation of a new drug. This mixed-methods study examined the accounts of 30 young female IDUs in Los Angeles, CA, USA from 2004 to 2006, who described the social context of initiating injection drug use and initiating ketamine injection. The analysis aimed to understand how the social context of young women’s injection events contributes to HIV/HCV risk. Women’s initiation into ketamine injection occurred approximately 2 years after their first injection of any drug. Over that time, women experienced changes in some aspects of the social context of drug injection, including the size and composition of the using group. A significant proportion of women described injection events characterized by a lack of control over the acquisition, preparation, and injection of drugs, as well as reliance on friends and sexual partners. Findings suggest that lack of control over drug acquisition, preparation, and injection may elevate women’s risk; these phenomena should be considered as a behavioral risk factor when designing interventions.

Background Prescription drug misuse among young adults is increasingly viewed as a public health concern, yet most research has focused on student populations and excluded high-risk groups. Furthermore, research on populations who report recent prescription drug misuse is limited. This study examined patterns of prescription drug misuse among high-risk young adults in Los Angeles (LA) and New York (NY), which represent different local markets for illicit and prescription drugs. Design and Methods Between 2009 and 2011, 596 young adults (16 to 25 years old) who had misused prescription drugs within the past 90 days were interviewed in Los Angeles and New York. Sampling was stratified to enroll three groups of high-risk young adults: injection drug users (IDUs); homeless persons; and polydrug users. Results In both sites, lifetime history of receiving a prescription for an opioid, tranquilizer, or stimulant was high and commonly preceded misuse. Moreover, initiation of opioids occurred before heroin and initiation of prescription stimulants happened prior to illicit stimulants. NY participants more frequently misused oxycodone, heroin, and cocaine, and LA participants more frequently misused codeine, marijuana, and methamphetamine. Combining prescription and illicit drugs during drug using events was commonly reported in both sites. Opioids and tranquilizers were used as substitutes for other drugs, e.g., heroin, when these drugs were not available. Conclusion Patterns of drug use among high-risk young adults in Los Angeles and New York appear to be linked to differences in local markets in each city for illicit drugs and diverted prescription drugs.

This chapter sheds light on the relationship between minorities, states and international security, and assesses the Bolzano/Bozen Recommendations on National Minorities in Inter-State Relations from the perspective of the complex nature of the minority problematique . First, it discusses the "minority problem": namely the perception of minorities as problematic entities in the context of the international system composed of nation-states. Then, it examines the international dimension of the "minority problem" because the processes of nation-building and state-formation have resulted in ethnically heterogeneous populations within nation-states that, in the vast majority of cases. The chapter concludes with a schematic presentation of the various interests and relationships that exist in the international society, between different types of actors, because of the existence of minorities. Keywords:Bolzano Recommendations; Bozen Recommendations; inter-State relations; international security; minority problem

The expression of anger is considered to be abnormal in depression, yet its role is only poorly understood. In the present study we sought to clarify this role by examining the moderating influence of the family environment on overall levels of anger expression and anger reactivity in depressed and non-depressed adolescents during conflictual interactions with their parents. One hundred and forty one depressed and non-depressed adolescent participants engaged in a problem-solving task with their parents during which their behavioral expression of anger and heart rate were recorded. The results demonstrate that general levels of parental anger in the family environment (as indicated by the overall level of expressed anger by the parents during the interactions) strongly moderates how depressed differ from non-depressed adolescents in terms of their anger, heart rate and reactivity. Overall, the findings suggest that in depressed adolescents anger is much less adaptively attuned to the environment, consistent with models that predict dysfunction in the regulation of anger that prevents depressed individuals responding adaptively to their social environment.

Longitudinal studies that research homeless persons or transient drug users face particular challenges in retaining subjects. Between 2005 and 2006, 101 mobile young injection drug users were recruited in Los Angeles into a 2-year longitudinal study. Several features of ethnographic methodology, including fieldwork and qualitative interviews, and modifications to the original design, such as toll-free calls routed directly to ethnographer cell phones and wiring incentive payments, resulted in retention of 78% of subjects for the first follow-up interview. Longitudinal studies that are flexible and based upon qualitative methodologies are more likely to retain mobile subjects while also uncovering emergent research findings.

Ketamine is a dissociative anesthetic with powerful sedative and hallucinogenic properties. Despite the wide variability in reported subjective experiences, no study has attempted to describe the particular factors that shape these experiences. This manuscript is based upon a sample of 213 young injection drug users recruited in New York, New Orleans, and Los Angeles with histories of ketamine use. Qualitative interviews focused on specific ketamine events, such as first injection of ketamine, most recent injection of ketamine, and most recent experience sniffing ketamine. Findings indicate that six factors impacted both positive and negative ketamine experiences: polydrug use, drug using history, mode of administration, quantity and quality of ketamine, user group, and setting. Most subjective experiences during any given ketamine event were shaped by a combination of these factors. Additionally, subjective ketamine experiences were particularly influenced by a lifestyle characterized by homelessness and traveling.

In recent years, epidemiological monitoring data has indicated sharp increases in prescription drug misuse. Despite these increases, little is known about the context or patterns associated with prescription drug misuse, particularly among youth or young injection drug users (IDUs). A three-city study of 213 young IDUs found prescription drug misuse to be pervasive, specifically the use of opioids and benzodiazepines. Particular practices not commonly associated with prescription drugs were reported, such as sniffing, smoking, and injection. Associated health risks included initiation into injection drug use, polydrug use, drug overdose, and drug dependency. A greater awareness of the potential health risks associated with prescription drug misuse should be incorporated into services that target IDUs, including street outreach, syringe exchanges, and drug treatment.

Tryptamines and phenethylamines are two broad categories of psychoactive substances with a long history of licit and illicit use. Profiles of users of recently emerging tryptamines and phenethylamines are nonexistent, however, since surveillance studies do not query the use of these substances. This manuscript describes the types, modes of administration, onset of use, and context of use of a variety of lesser known tryptamines and phenethylamines among a sample of high-risk youth. Findings are based upon in-depth interviews with 42 youth recruited in public settings in Los Angles during 2005 and 2006 as part of larger study examining health risks associated with injecting ketamine. Youth reported that their use of tryptamines and phenethylamines was infrequent, spontaneous, and predominately occurred at music venues, such as festivals, concerts, or raves. Several purchased a variety of these “research chemicals” from the Internet and used them in private locations. While many described positive experiences, reports of short-term negative health outcomes included nausea, vomiting, diarrhea, disorientations, and frightening hallucinations. These findings, based upon pilot study data, move toward an epidemiology of tryptamine and phenethylamine use among high-risk youth.

A fundamental concern for well-being of various individuals and communities who have been involved in or affected by ethnic conflict underscores all complex power-sharing agreements. The central premise behind complex power-sharing is that ethnic groups who are recognized by and accommodated within state are far less likely to challenge its authority or to threaten its territorial integrity. Legal practices, including human and minority rights, are increasingly identified as fundamental prerequisites for good governance by both state and non-state actors and feature prominently in complex power-sharing agreements. It may well be that this oversight is a consequence of a methodological predisposition towards social science positivism, which tends to avoid normative claims and categories to the detriment of empirical analysis in this area. This chapter aims to redress the balance by examining the implications of a rights-based response to ethnic conflict as disclosed in various complex power-sharing agreements studied in this book. Keywords: complex power-sharing agreements; ethnic conflict; human rights; minority rights; rights-based response; territorial integrity

To what extent is honesty or truthfulness morally obligatory in trade and advertising practices? It is argued here what while we have a general right, in business as elsewhere, not to be lied to, we have no general right, either in our business or other pursuits, not to be deliberately deceived. Certain restrictions on deceptive practices in trade and advertising, even unintentionally deceptive practices, are, even so, morally defensible: viz. where the practice would mislead reasonable people to a material degree or where it would mislead especially vulnerable people who are predictably unreasonable. It is suggested that a code of practice for trade and advertising which exaggerates the degree of truthfulness which is morally obligatory may actually be corrupting in effect.

A philosopher looks at the scepticism of some of her colleagues about just what the study of ethics can contribute to ethical business, and argues that its main purpose is to help business people to engage in constructive ethical dialogue in society as well as in their corporation. The author is a regular contributor to this Review, and Director of the Centre for Business and Professional Ethics, University of Leeds, Leeds LS2 9JT.

Eighty women described the most difficult aspects of living with HIV infection. Content analysis revealed four themes: fear, limitation, symptoms, and emotions. Fears related to disclosure and stigma were more frequently described than fears of dying. Limitations were financial, sexual/reproductive, and physical. The physical limitations were related to the presence of symptoms leading to a wide range of emotions.

After 1945, national minority rights lost their hitherto independent standing in international relations and were subsumed within the newly created universal human rights regime. The failure of the League of Nations discredited national minority rights and the minorities themselves tended to be viewed with suspicion owing to the wartime complicity of certain national minority leaders with Nazi aims in Central and Eastern Europe — though it should also be pointed out that these aims cleverly exploited national minority fears and aspirations within the region. Consequently, unlike in previous eras, national minority rights were considered contrary to international peace and security. The inter-war system of national minority guarantees was not resurrected and no new national minority rights provisions were included in the various agreements of the 1940s and 1950s which laid the foundations of the Cold War human rights regime. This chapter examines the various political calculations and normative assumptions which underlay the Cold War universal human rights regime that gave such short shrift to the particular problems of national minorities.