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This essay is about the improbable emergence of written language six millennia ago that gave rise to the even more improbable, highly sophisticated reading brain of the twenty-first century. How it emerged and what it comprises--both in its most basic iteration in the very young reader and in its most elaborated iteration in the expert reader--is a story with several important lessons for how we think about reading development and how we approach reading challenges like dyslexia. For, an understanding of how the reading brain develops gives educators a unique lens on what the child has to learn, what the teacher would be wise to teach, and why the organization of the brain of an individual with dyslexia has precious little to do with reading.

According to the Geneseo Migrant Center, 1 million to 3 million migrant workers leave their homes each year to work in agricultural fields, many coming to the United States from homes in Mexico and Latin America. The Pew Hispanic Center recently reported that one in four U.S. farm workers is an unauthorized immigrant, meaning they lack either a legal green card or U.S. citizenship. The contributions of these workers to their local economies are indisputable. For many of these workers, however, opportunity often ends at the crop line. Efforts are under way across the country to open more doors to more students, particularly to children of unauthorized immigrants. As efforts continue on Capitol Hill, colleges are doing their part to provide opportunities for the migrant workforce. In this article, the author considers the importance of the undocumented students to local and national economies and explores ways colleges are creating opportunities for foreign workers.

"Ingles Sin Barreras" is an English-language program that is highly advertised on Spanish-language television in the United States, to the point that it has become a pop-culture phenomenon. In this article, I argue that few people actually use it to learn English, but instead consume it as a symbol of national belonging. This article puts ideologies from the program itself into conversation with ethnographic data from migrants who have consumed the program. "Ingles Sin Barreras" is a commodity that mystifies inequitable power relations among stakeholders, and serves as a powerful symbol of the contradictions of national belonging for migrants. By synthesizing perspectives from both the program and its users, this article explores new linkages between theories of consumption and language ideology.

Since its inception at the turn of the last century, adult education English as a Second Language (ESL) instruction in the United States has been entwined with immigration processes and ideas of the nation. In spite of current uncertainty about the overhauling of federal immigration policy, increasingly anti-immigrant laws in states such as Arizona, and attempts to restrict immigration in cities like Hazelton, Pennsylvania, demand for ESL instruction continues to be the fastest-growing sector of adult basic education. Adult educators need to know about the origins of English-language teaching in the United States because the past can reveal ways to better shape the future. This article offers a history of adult education ESL instruction in the United States, followed by a discussion of key issues in the immigration literature that impact adult educators and their work in program development and classroom teaching.

Introduction: People with haemophilia rely on specialists for their care, yet the specific dosing regimens of treatments prescribed by these specialists have not been widely studied. Aim: The objective of this study is to describe trends in clinician prescribing practices for the management of haemophilia in the United States (US). Methods: We administered surveys to members of the Hemostasis and Thrombosis Research Society via paper surveys at its in‐person annual symposia in 1999 and 2015, and an online survey in 2021. The surveys collected information on haemophilia treatments including factor dosing, inhibitor therapy and gene therapy. Results: Clinicians treating haemophilia for more than 50% of their practice time have increased from 37.5% of respondents in 1999 to 46.3% in 2021. Clinicians prescribing factor concentrates at >40 units/kg for routine bleeding events increased from 0% in 1999 to 29.3% in 2021 in haemophilia A (HA) and from 22.5% to 87.8% in haemophilia B (HB). In 2021, the clinicians reported prescribing emicizumab to treat HA patients (>89.5% paediatric, >85.7% adult) with or without inhibitors at least some of the time. Approximately 78.0% of respondents reported that they expected to recommend gene therapy at least some of time. Conclusion: These data indicate changing trends in prescribing practices among US haemophilia specialists during the past 22 years. Preference for high doses of factor (>40 units/kg) has increased during this period. Emicizumab prophylaxis has been prescribed for patients with and without HA inhibitors. Clinicians expect gene therapy to have value for some haemophilia patients. [ABSTRACT FROM AUTHOR]

Background: Heart failure readmissions are common, though some are preventable through evidence-based management. Local Problem: Despite outperforming national benchmarks for 30-day readmissions, compliance with an evidence-based institutional heart failure management pathway was inconsistent. The purpose of this project was to reduce 30-day heart failure readmission rates through an educational intervention and an electronic health record (EHR) redesign. Methods: The cardiac services nursing leadership team conducted an education and documentation needs assessment to identify knowledge gaps and practical barriers to effective utilization of evidence-based interventions for heart failure management. Interventions: This intervention included an Advanced Cardiovascular Education (ACE) Academy and an EHR workflow redesign for clinical and supportive nursing staff. Results: The 30-day heart failure readmission rates reduced immediately following the intervention, and rates continued to decrease over a 3-year follow-up. Conclusions: Even among hospitals outperforming national benchmarks, 30-day heart failure readmissions can be reduced and sustained with enhanced education and EHR redesign. [ABSTRACT FROM AUTHOR]

Campus sexual assault affects a large proportion of college students in the United States, most of whom are women. There is little research on the federal complaint mechanism from the standpoint of survivors accessing it, or on whether existing justice mechanisms meet survivors' needs. This qualitative study asks how survivors define justice, and how policy might help survivors achieve justice. To answer these questions, qualitative data were collected and analyzed through interviews with survivors and campus administrators, and focus groups with survivor advocates. These data are analyzed within the context of an ecological framework and produce the just prevention theory for policymaking on campus sexual assault. The just prevention theory argues that genuine justice for survivors must be pursued through a framework of prevention. This theory reconceives justice in a fundamental way: while justice may include other response measures, it must include prevention. [ABSTRACT FROM AUTHOR]

Argues that a reduction of U.S. and Soviet nuclear arsenals to one-tenth their present sizes would maintain deterrent capabilities while exerting a stabilizing influence on the balance of terror. Discussion of alternative futures that has characterized the nuclear weapons debate; Adoption of finite or minimum deterrence; Comparison of a finite deterrence force and current superpower nuclear arsenals.

This article reports on the history and status of jobs banks in the U.S. and their impact on the labor market information systems in 1974. The efforts of the U.S. government to improve the performance of the labor market information systems depended on job banks. The job bank concept was developed by the Maryland Department of Employment Security in 1968. The Baltimore Job Bank became operational in May 1968. Job banks use computers to record and store job openings known to the Employment Service in a given area. There was a rapid expansion of the number of operational job banks in the country since 1969. However, the first phase of the U.S. job bank program did not perform well to achieve its major goals.

The article examines the structure and scope of public sector appeals procedures and compares them with private sector procedures in the U.S. in 1970. There is a rapid spread of collective bargaining for public employees, and it has been accompanies by the same growth in negotiated grievance procedures in the public sector. As compared with one third of private sector employees, one fifth of public employees have access to negotiated appeals channels. Based on current trends, the proportions of both public and private employees covered by negotiated procedures will be the same within a few years.

Local and area unemployment has increased interest in and the importance of state and local unemployment estimates. This study examines the accuracy of such estimates by comparing those provided by the 1960 Census of Population with those of the Bureau of Employment Security of the United States Department of Labor (for April 1960). Additional comparisons are also made with national and regional Current Population Survey estimates for the same month. The study shows that there was considerable divergence between the BES and Census estimates of state and local unemployment, thus raising the question of the adequacy of these estimates for purposes of resting policy decisions on them. [ABSTRACT FROM AUTHOR]

Background: Veterans Health Administration (VHA) is committed to providing high-quality care and addressing health disparities for vulnerable Veterans. To meet these goals, VA policymakers need guidance on how to address social determinants in operations planning and day-to-day clinical care for Veterans.Method: MEDLINE (OVID), CINAHL, PsycINFO, and Sociological Abstracts were searched from inception to January 2017. Additional articles were suggested by peer reviewers and/or found through search of work associated with US and VA cohorts. Eligible articles compared Veterans vs non-Veterans, and/or Veterans engaged with those not engaged in VA healthcare. Our evidence maps summarized study characteristics, social determinant(s) addressed, and whether health behaviors, health services utilization, and/or health outcomes were examined. Qualitative syntheses and quality assessment were performed for articles on rurality, trauma exposure, and sexual orientation.Results: We screened 7242 citations and found 131 eligible articles-99 compared Veterans vs non-Veterans, and 40 included engaged vs non-engaged Veterans. Most articles were cross-sectional and addressed socioeconomic factors (e.g., education and income). Fewer articles addressed rurality (N = 20), trauma exposure (N = 17), or sexual orientation (N = 2); none examined gender identity. We found no differences in rural residence between Veterans and non-Veterans, nor between engaged and non-engaged Veterans (moderate strength evidence). There was insufficient evidence for role of rurality in health behaviors, health services utilization, or health outcomes. Trauma exposures, including from events preceding military service, were more prevalent for Veterans vs non-Veterans and for engaged vs non-engaged Veterans (low-strength evidence); exposures were associated with smoking (low-strength evidence).Discussion: Little published literature exists on some emerging social determinants. We found no differences in rural residence between our groups of interest, but trauma exposure was higher in Veterans (vs non-Veterans) and engaged (vs non-engaged). We recommend consistent measures for social determinants, clear conceptual frameworks, and analytic strategies that account for the complex relationships between social determinants and health. [ABSTRACT FROM AUTHOR]

The article focuses on the analysis of legal structures and approaches to through-running and regional transit in New York. Topics discussed include overview of the benefits of through-running in creating capacity and providing customers with additional flexibility; current and future plans for infrastructure development in the New York metropolitan region; and addressing issues of rail service under the various structures such as labor and staffing, fares, and management and decision-making.

The article presents studies about labor management relations in the U.S. Harold Davey of Iowa has written a series of short articles on labor dispute arbitration. Mollie H. Bowers of Maryland has started research on mediation as an essential part of the dispute settlement process in grievances in both public and private sectors. George Sulzner and David Bloodsworth have developed case studies on the applicability of dispute settlement techniques on labor management relations in social and political systems

Few studies have examined factors related to problem drinking and drug use in Black sexual assault victims. Given that sexual assault and histories of trauma are associated with substance abuse in victims, research is needed to determine what factors may be related to these outcomes for Black survivors. Furthermore, child sexual abuse (CSA) is a risk factor for substance abuse, but no studies have examined correlates of substance abuse outcomes separately according to CSA history. This study examines a large diverse sample of Black sexual assault victims (N = 495) to determine the associations of demographics, trauma history, assault characteristics, and postassault psychosocial factors with problem drinking and drug use using multivariate regressions. Traumatic life events, using substances to cope and self-blame, were associated with greater problem drinking and drug use. Implications for practitioners and policymakers are discussed. [ABSTRACT FROM AUTHOR]

This is the first study to test concurrently the effectiveness of four treatment programs for patients with serious mental illness. Three-year outcome data on utilization and functioning demonstrated important positive changes for seriously mentally ill veterans enrolled in specialized, enhanced inpatient and community case management treatment programs, when compared to patients in an enhanced day treatment program or traditional standard care. [ABSTRACT FROM AUTHOR]

Under Title I of the ADA, individuals who believe they have been subjected to disability-based employment discrimination may file an administrative charge. This article looks at who files charges; over what issues, and with what outcomes in both Equal Employment Opportunity Commission (EEOC) field offices, and state and local fair employment practice agencies (FEPAs). The data for the article are computerized records of all ADA charges filed through March 31, 1998. The data indicate that individuals who rely on a FEPA to investigate their charge have a greater likelihood of obtaining a beneficial outcome than individuals who rely on the EEOC, but proportionately more individuals receiving a beneficial outcome are likely to receive monetary benefits from the EEOC than from a FEPA. Further, those who receive beneficial outcomes will probably receive greater monetary benefits from charges investigated by the EEOC than from those investigated by a FEPA. [ABSTRACT FROM AUTHOR]

Background & Aims: Multiple randomized controlled trials (RCTs) have been conducted to determine therapeutic efficacy of the biological agents for the inflammatory bowel diseases (IBD). However, the external validity of findings from RCTs might be compromised by their stringent selection criteria. We investigated the proportion of patients encountered during routine clinical practice who would qualify for enrollment into a pivotal RCT of biological agents for IBD. Methods: We performed a retrospective cohort study of adult patients with moderate–severe IBD who presented to a tertiary referral center. Inclusion and exclusion criteria were extracted from published RCTs of biologics approved by the Food and Drug Administration and applied to the study population. Results: Only 31.1% of 206 patients with IBD (34% with Crohn''s disease [CD], 26% with ulcerative colitis) would have been eligible to participate in any of the selected RCTs. Patients would have been excluded because they had stricturing or penetrating CD, took high doses of steroids, had comorbidities or prior exposure to biologics, or received topical therapies. Of the trial-ineligible patients with ulcerative colitis, 23.3% had colectomies, and 31.7% received infliximab, with a 63.2% response rate. Approximately half (49.4%) of the 82 trial-ineligible patients with CD received biological therapies, with lower response rates (60%) than trial-eligible patients (89%; P = .03). Conclusions: Most patients with moderate–severe IBD evaluated in an outpatient practice would not qualify for enrollment in a pivotal RCT of biological reagents; this finding raises important questions about their therapeutic efficacy beyond the clinical trial populations. Additional evaluation of the transparency of RCT design and selection criteria is needed to determine whether trial results can be generalized to the population. [Copyright &y& Elsevier]

. This study describes health-related quality of life (HRQoL) of persons with haemophilia A in the United States (US) and determines associations between self-reported joint pain, motion limitation and clinically evaluated joint range of motion (ROM), and between HRQoL and ROM. As part of a 2-year cohort study, we collected baseline HRQoL using the SF-12 (adults) and PedsQL (children), along with self-ratings of joint pain and motion limitation, in persons with factor VIII deficiency recruited from six Haemophilia Treatment Centres (HTCs) in geographically diverse regions of the US. Clinically measured joint ROM measurements were collected from medical charts of a subset of participants. Adults ( N = 156, mean age: 33.5 ± 12.6 years) had mean physical and mental component scores of 43.4 ± 10.7 and 50.9 ± 10.1, respectively. Children ( N = 164, mean age: 9.7 ± 4.5 years) had mean total PedsQL, physical functioning, and psychosocial health scores of 85.9 ± 13.8, 89.5 ± 15.2, and 84.1 ± 15.3, respectively. Persons with more severe haemophilia and higher self-reported joint pain and motion limitation had poorer scores, particularly in the physical aspects of HRQoL. In adults, significant correlations (P < 0.01) were found between ROM measures and both self-reported measures. Except among those with severe disease, children and adults with haemophilia have HRQoL scores comparable with those of the healthy US population. The physical aspects of HRQoL in both adults and children with haemophilia A in the US decrease with increasing severity of illness. However, scores for mental aspects of HRQoL do not differ between severity groups. These findings are comparable with those from studies in European and Canadian haemophilia populations. [ABSTRACT FROM AUTHOR]

This article explores the ways in which Mexican transmigrants in the USA discursively construct national identities in relation to the mediated message of a television advertisement for an English-language self-study program marketed to Spanish speakers, called Ingles Sin Barreras. Using narrative analysis of the advertisement and critical discourse analysis of a focus group, the author considers the ways in which identities and ideologies of language and language learning come to be intertwined and circulate across national boundaries. [ABSTRACT FROM AUTHOR]

Do teacher candidates who identify as White and European American think about issues of difference in ways that vary distinctly from teacher candidates who identify as Latina/o or Hispanic? In this article, we engage with the literature on culturally relevant teaching that suggests teacher candidates of color are more likely to have some of the characteristics of culturally responsive teachers than are White teacher candidates when they enter teacher preparation programs. By comparing the attitudes of teacher candidates from a majority Hispanic-serving university and a university that serves mostly White and European American students, we question the idea that certain bodies are coterminous with particular ideologies. [ABSTRACT FROM PUBLISHER]

Summary. To describe the study design, procedures and baseline characteristics of the Haemophilia Utilization Group Study - Part Va (HUGS Va), a US multi-center observational study evaluating the cost of care and burden of illness in persons with factor VIII deficiency. Patients with factor VIII level ≤30%, age 2-64 years, receiving treatment at one of six federally supported haemophilia treatment centres (HTCs) were enrolled in the study. Participants completed an initial interview including questions on socio-demographical characteristics, health insurance status, co-morbidities, access to care, haemophilia treatment regimen, factor utilization, self-reported joint pain and motion limitation and health-related quality of life. A periodic follow-up survey collected data regarding time lost from usual activities, disability days, health care utilization and outcomes of care. HTC clinicians documented participants' baseline clinical characteristics and pharmacy dispensing records for 2 years. Between July 2005 and July 2007, 329 participants were enrolled. Average age was 9.7 years for children and 33.5 years for adults; two-thirds had severe haemophilia. The distributions of age, marital status, education level and barriers to haemophilia care were relatively consistent across haemophilic severity categories. Differences were found in participants' employment status, insurance status and income. Overall, children with haemophilia had quality of life scores comparable to healthy counterparts. Adults had significantly lower physical functioning than the general US population. As one of the largest economic studies of haemophilia care, HUGS Va will provide detailed information regarding the burden of illness and health care utilization in the US haemophilia A population. [ABSTRACT FROM AUTHOR]

The US Institute of Medical sponsors a “Summit on Integrative Medicine and the Health of the Public” on February 25–27, 2009. A prestigious body of speakers and attendees created a dynamic conference in which the content and discussions provided vital information for transforming the US health care system. Topics included: patient-centered care, the scientific basis of integrative medicine, health care financing reform and value-driven care, and mind-body relationships and health. [ABSTRACT FROM PUBLISHER]

Previous research has assumed that rape reporting is unique, but no study has systematically tested this assumption. The present study used a probability sample of female victims from the National Violence Against Women Survey to compare factors affecting rape and physical assault reporting using multinomial logit regression. Overall, results suggested that there was similarity in reporting decisions between rapes and physical assaults in terms of main effects. However, interactions suggested that age, marital status, and physical force each influenced reporting differently by assault type. Implications of these results are discussed and directions for future research are offered. [ABSTRACT FROM AUTHOR]

The article presents the author's insight related to the naturalization activities in the U.S. that encourage service learning. She notes that students should be exposed to various aspects of social studies that reflect the democratic society of the country, and to be involved in service learning in which students could reflect on their experiences. She relates her experiences with her grandmother who advocates universal principles to address prejudice, hatred, and discrimination.

The article discusses a court case wherein the plaintiff was denied of his application for asylum by the Board of Immigration Appeals (BIA) in 2002. The Immigration Judge (IJ) has granted the asylum, but it was reversed by the BIA claiming that the plaintiff did not rise to the level of persecution. The First Circuit of the U.S. Court of Appeals suggests administrative court to evaluate the plaintiff according to the In re T-Z- rules since neither IJ nor BIA has applied the correct standard.

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The present study examined current and lifetime psychiatric morbidity, chest pain, and health care utilization in 229 patients with noncardiac chest pain (NCCP), angina-like pain in the absence of cardiac etiology. Diagnostic interview findings based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) revealed a psychiatrically heterogeneous sample of whom 44% had a current Axis! psychiatric disorder. A total of 41% were diagnosed with a current anxiety disorder, and 13% were diagnosed with a mood disorder. Overall, 75% of patients had an Axis I clinical or subclinical disorder. Lifetime diagnoses of anxiety (55%) and mood disorders (44%) were also prevalent, including major depressive disorder (41%), social phobia (25%), and panic disorder (22%). Patients with an Axis I disorder reported more frequent and more painful chest pain compared with those without an Axis I disorder. Presence of an Axis I disorder was associated with increased life interference and health care utilization. Findings reveal that varied DSM-IV Axis I psychiatric disorders are prevalent among patients with NCCP, and this psychiatric morbidity is associated with a less favorable NCCP presentation. Implications for early identification of psychiatric disorders are discussed. [ABSTRACT FROM AUTHOR]

The article provides a discussion on trade adjustment assistance (TAA) statutes in the U. S. The U. S. Congress provides TAA to employees affected by competition in production. The article describes the process of providing TAA and presents reviews of cases by the U. S. Court of International Trade.

The 1990 Americans with Disabilities Act (ADA) was expected to decrease discrimination against people, with disabilities. However, discrimination against people with psychiatric disabilities may exist in the legal system that is charged with implementing the ADA. This study describes and compares the characteristics of people with psychiatric and non-psychiatric disabilities who filed employment discrimination lawsuits under Title I of the ADA from 1993 to 2001. The Article examines actual and perceived outcomes of these lawsuits, features of the surrounding legal process, effects of psychiatric disability status on receiving a benefit from litigation, and predictors of overall satisfaction with the experience of bringing an ADA Title I claim. The study consisted of telephone interviews with a national stratified quasi-random sample of N=537 persons who had filed ADA employment discrimination lawsuits in federal court. The study compared subsamples of n=148 persons with psychiatric disabilities and n=222 persons with non-psychiatric disabilities. The primary outcome was receiving a benefit from filing an ADA Title I lawsuit, defined as a court ruling in favor of the plaintiff or a settlement between the parties, with the plaintiff's confirmation of having received some benefit. The secondary outcome was the degree of overall satisfaction with the experience of bringing a claim of employment discrimination from the initial charging process through litigation. The study finds that people with psychiatric disabilities fared significantly worse in employment discrimination lawsuits than their counterparts with non-psychiatric disabilities, controlling for other significant predictors of litigation outcome, including health status, plaintiffs education, reasons for the lawsuit, and assistance by a lawyer. Plaintiffs with psychiatric disabilities were also significantly less satisfied with the overall process of filing a claim of employment discrimination and bringing a lawsuit under the ADA. The effects of poor outcome on dissatisfaction were mediated by perceived unfairness, lack of "voice," and lack of procedural justice in the charge process and litigation. These disparities are not easily explained by differences in the law, the behavior of employers or lawyers, or the effects of psychiatric illness on perception. Even accounting for the influence of outcome on retrospective perception of justice, people with psychiatric disabilities experienced less procedural justice than other. While the disparities are clear, the causes are not. There is no reason to suspect that actors in the legal system--personnel in state agencies, judges, court clerks, lawyers for the defendants, and even lawyers for the plaintiffs--are immune from prejudicial attitudes shaped by the stigma of mental illness, but there is also no reason to jump to the conclusion that the system is rife with "sanism." What should not be doubted is the need for a vigorous response to these findings to ensure that the system intended to protect people from discrimination does not discriminate. [ABSTRACT FROM AUTHOR]

The article examines the position of the U.S. in its global war on terror. The U.S. failed to understand the nature of the threat. The dysfunctional organization of the government impedes the formulation of effective policies to deal with terrorism issues. The administration of President George W. Bush did its best to link the September 11, 2001 terrorists attacks with the al-Qaeda and Iraqi President Saddam Hussein.

Effects of the September 11, 2001 terrorist attacks in the USA were investigated in 25 patients with obsessive compulsive disorder and 27 normal controls 4-6 months after the attacks. Participants completed a 15-item questionnaire to retrospectively assess changes in mood, cognition, behavior and somatic complaints since September 11, 2001. Overall, both patients with obsessive compulsive disorder and normal controls reported minor changes in mood, behavior and somatic complaints. However, normal controls reported severe to extreme initial impact, slightly more cognitive symptoms (uncertainty about the future, intrusive recollections and greater desire to be with loved ones) and a slightly greater degree of overall impact on emotion and behavior at 1, 2 and 3 months after September 11 than did patients with obsessive compulsive disorder. Results support previous research that has found a relatively minor lasting impact of September 11 on both clinical and normal populations. Differences in cognition and coping mechanisms between normal controls and patients with obsessive compulsive disorder are proposed. [ABSTRACT FROM AUTHOR]

Highlights the 40th anniversary performances of the Cincinnati Ballet and the inaugural exhibition of the Julius Fleischmann Collection of theatrical designs at the Cincinnati Art Museum from October 18 to 20, 2002, in which both events focused on the dance company, Ballet Russe de Monte Carlo (BRdeMC). Background on Fleischmann; Link between Fleischmann and the Cincinnati Ballet; Information on the dance company, BRdeMC; Significant context of the ballet programming in Cincinnati.

Background: Increasing supplies of dermatologists and family physicians have been associated with earlier detection of malignant melanoma. We investigated whether physician supply was similarly related to incidence and mortality rates of malignant melanoma. Methods: Using the state tumor registry, we determined melanoma incidence and mortality rates for the years 1993 to 1995 for each Florida County. We measured physician supply for each Florida county using data from the 1994 American Medical Association Physician Masterfile. Multiple linear regression analysis was used to determine relationships between physician supply and melanoma incidence and mortality rates, controlling for other county-level characteristics. Results: Among male patients, an increasing supply of family physicians was associated with higher melanoma incidence and lower melanoma mortality. Increasing supplies of dermatologists were associated with lower overall melanoma mortality rates, and increasing supplies of general internists were associated with higher overall melanoma mortality. Conclusion: We found that melanoma incidence and morality rates varied substantially among Florida's 67 counties, and that differences in physician supply explained some of this variability. Further study is needed to confirm these findings and to elucidate possible mechanisms that would account for these associations. [ABSTRACT FROM AUTHOR]

Groundwater and associated nutrients discharge from the beachface to the Delaware Estuary at Cape Henlopen, Delaware, and appear to contribute significantly to the ecological structure of the adjacent intertidal and subtidal benthic communities. The cross-sectional distributions of salinity and nutrient concentrations at one seepage site indicate that there are two distinct groundwater masses that mix with seawater in the sandy beachface during discharge. The dissolved nutrient concentrations in the beachface at this site are substantially higher than those found in the adjacent estuarine surface water. Nutrient concentrations and distribution in the beachface water reflect: (1) the discharge of nutrient-rich upland water; (2) mixing between nutrient-rich groundwater and estuarine water; and (3) diagenetic recycling of estuarine organic material in the beachface mixing zone. Simple mixing and hydrological models are used to determine the relative magnitude of upland and diagenetic contributions and to estimate absolute nutrient discharges across the beachface. Nutrient fluxes during the summer at this site are sufficient to support carbon fixation rates of 4–17 mol C/m/year along the beachface. These nutrient fluxes are substantially higher than can be supported by the upland discharge alone. This suggests that beachfaces serve as traps and reservoirs of estuarine particulate matter and associated nutrient elements. During the summer, when samples were collected at the Cape Henlopen site, nutrient concentrations in the estuary are low and the remineralization of particles in the beachface may contribute significantly to the productivity of the dense plant and animal communities found adjacent to the beachface. [Copyright &y& Elsevier]

This study examined demographic and psychosocial correlates of suicidal ideation and suicide attempts in women with histories of sexual assault in childhood and/or adulthood identified from a national sample of women. Multivariate analyses showed that women with histories of sexual assault in both childhood and adulthood reported significantly greater odds of lifetime suicide attempts, controlling for demographic factors and other psychosocial characteristics. As predicted, younger age (marginal), stressful life events (marginal), depression, PTSD, and alcohol dependence symptoms were also significantly associated with suicidal ideation. Furthermore, number of lifetime traumatic events and depression were each associated with lifetime odds of suicide attempts. Implications for studying the role of sexual trauma and other psychosocial factors in relation to women's suicidal behavior are discussed. [ABSTRACT FROM AUTHOR]

Describes the roles of victim and offender alcohol use in the outcomes of sexual assault incidence in the United States. Risk of lifetime sexual victimization; Questions regarding assault characteristics; Effects of alcohol on human aggression.

Explores the use of local safety-nets to increase access to health care and insurance in the United States. Safety-net providers including public hospitals, large academic medical centers and community health clinics; Types of pressures affecting costs and revenues of safety-net providers; Basic strategies for safety-net providers concerned about maintaining health care access to the uninsured.

The role of offender preassault alcohol use (as perceived by victims) in the outcomes of rape incidents (N = 362) was analyzed using data from the 1992-1996 National Crime Victimization Survey. Offender preassault alcohol use was hypothesized to be related to more risky assault characteristics (e.g., stranger assaults and weapons) and more severe assault outcomes (e.g., completed rapes and physical injury). As predicted, offender alcohol use was associated with stranger assaults, night assaults, outdoor locations, and greater victim resistance. Logistic regression analyses showed that offender alcohol use was associated with less likelihood of rape completion and unrelated to physical injury when demographic variables and assault characteristics were controlled. Suggestions for future research on the role of alcohol in rape incidents are presented. [ABSTRACT FROM AUTHOR]