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While problem-solving courts represent one area in which rehabilitative efforts have expanded within correctional settings as "coercive penal care," still unexplored is how the blend of rehabilitative and punitive practices might evolve over time. By conducting interviews and observing a new reentry court, we explore how the court's navigation of coercive penal care transforms over time. We argue that initially, the introduction of rehabilitative goals was mostly subverted by the court's existing punitive criminal legal system and organizational structure. This occurred through court actors prioritizing internal over external goals and metrics in the program, and articulating self-responsibilization narratives for success. As the court progressed, court actors shifted toward emphasizing individualism. Increased individualism occurred in recognition of the complex barriers that participants faced, but presented a double-edged sword: actors focused more on the individual needs of participants beyond program requirements, but also increased individual accountability by participants. This greater emphasis on individualization also allowed court actors to resolve sometimes competing rehabilitative and punitive goals through increased discretion. [ABSTRACT FROM AUTHOR]

This note summarizes extant research on civil legal aid, which includes provision of legal services for indigent and low-income individuals, and its applications for DV and IPV victims, and concludes with suggestions for improving service delivery and research in the field. Results of searches of online databases for peer-reviewed and non-peer reviewed articles, reports, analyses, and evaluations of civil legal aid in the United States were analyzed and critically assessed. Civil legal aid is a promising but underfunded and underexplored avenue for responding to and reducing domestic violence (DV), intimate partner violence (IPV), and their devastating effects. Providing civil counsel in divorce, custody, and protective order proceedings can significantly improve outcomes for DV and IPV victims and their children as well as serve as a cost-effective strategy for reducing violence and generating positive social returns., Author(s): Jacqueline G. Lee [sup.1] , Bethany L. Backes [sup.2] Author Affiliations: (Aff1) 0000 0001 0670 228X, grid.184764.8, Department of Criminal Justice, Boise State University, , 1910 University Drive, 83725, [...]

Competency based surgical training uses proficiency of technical skills to quantify surgical competency. We believe this is an over simplification of what is required to be a competent surgeon. This work aims to illuminate the attributes of a mature, competent, thinking surgeon. A bespoke (or custom) tailor is highly trained craftsman who produces unique items of clothing to the customers' requirements. This paper uses the practice of expert bespoke tailoring as a metaphor for illuminating surgical training and practice. A sustained and evolving dialogue with a single eminent tailor identified a number of emergent themes. A three-year iterative process included wide reading, interviews, observation, discussion and reflection. These emergent themes have produced a provisional working framework for exploring non-technical domains of surgical competence. Surgical practice is a complex process, which interweaves non-technical and technical elements in a seamless harmonious marriage of physical and mental processes. These processes need to be more clearly defined to allow the most effective training of future surgeons in the limited time now available. We discuss the benefits of illuminating these hidden facets of surgical practice, pointing out the limitations of defining competency in terms of knowledge acquisition and technical skills. If we are to train balanced, thinking surgeons for future surgical practice, and the training of future surgeons, has to be viewed as a complex integrated process rather than a collection of isolated domains.

Introduction: Endometrial lesions are morphologically diverse and uncommon on cervical smears, with its detection rate and associated diagnostic categories uncharacterized. In this study, cervical smears matched to histologically proven endometrial hyperplasias and carcinomas were reviewed and compared with cervical in‐situ‐carcinomas/carcinomas, aiming to detail the diagnostic performance of cervical smears for upper tract and glandular lesions. Methods: Pathology reports of cervical smears, hysterectomies, endometrial and cervical biopsies from 1995 to 2021 were retrieved. Diagnoses of cervical smears were matched to endometrial hyperplasias and carcinomas, or cervical carcinomas and reviewed. Results: Totally 832 cervical smears (272 cervical carcinomas, 312 endometrial carcinomas, and 248 hyperplasias) were included. Considering all cytologic glandular diagnosis as positive, the detection rate of cervical adenocarcinoma‐in‐situ was the highest (64.3%), followed by cervical adenocarcinoma (63.8%), endometrial carcinoma (31.7%), and hyperplasia (with atypia–8.5%; without atypia–2.3%) (p < 0.001). Endometrial hyperplasia was most often diagnosed as atypical squamous cells of undetermined significance (ASCUS) (5.0%) or atypical glandular cells, not otherwise specified (3.6%) without indication of endometrial origin. For endometrial carcinomas, higher FIGO grading and endocervical involvement were associated with higher detection rates across all diagnostic categories (p = 0.002–0.028). High FIGO grade was associated with suspicious/favor neoplastic (C4) (31.1%vs10.3%, p < 0.001) and carcinoma (C5) (17.8% vs. 5.6%, p = 0.005) categories, but not for all glandular diagnoses combined (33.3% vs. 31.0%, p = 0.761). Conclusion: Detection rates for endometrial lesions are lower than cervical lesions but not insignificant. Endometrial hyperplasia should be recognized as a differential of human papilloma virus‐negative ASCUS and prompt consideration of investigation of the upper genital tract. [ABSTRACT FROM AUTHOR]

This article discusses two important issues in the healthcare field: sexual harassment and incivility. The first article focuses on sexual harassment in the healthcare workforce and presents a prototype educational tool that uses virtual reality (VR) to address this issue. The study found that participants preferred VR training and that it was effective in promoting cultural change. The second article explores incivility in healthcare education and its negative impact on students' learning experience. The authors emphasize the need to address and prevent incivility to create a positive and supportive learning environment. Both articles provide valuable insights and recommendations for healthcare professionals and educators. [Extracted from the article]

Objectives Although the Patient Centered Medical Home is a considered an optimal model for care, some children still do not receive care in this model. Beyond the clinical and practitioner factors known to affect having a medical home, family and environmental risks [referred to as adverse childhood experiences (ACE)] may also be associated with having a medical home. This study's purpose was to examine whether family and environment risks are associated with children having a medical home. Methods Data from the nationally representative, cross-sectional 2011-2012 National Survey of Children's Health telephone survey were used (N = 95,677). Analyses were conducted to describe the sample characteristics and determine the association between family and environmental risks and whether a child has a medical home. A subset of risks were modeled from the seminal study of ACEs. Results Nearly one-quarter of parents reported that their children experienced at-least one ACE. Compared to children who experienced no ACEs, children who experienced at least one ACE, or other family and environmental risks, had lower odds of having a medical home than those whom did not. Logistic regressions showed that cumulative ACEs (odds ratio (OR) 0.76; 95 % confidence interval (CI) 0.65-0.90) as well as other family and environmental risks (OR 0.36, 95 % CI 0.26-0.51) were related to lower odds of having a medical home. Conclusions This study suggests that family and environmental risks, including ACEs, impact parental report of a child having a medical home and that a dosage effect may exist. ACEs and other risk factors must be considered when providers care for children at-risk of experiencing negative events, particularly multiple negative events., Author(s): Jacqueline Baron-Lee[sup.1] , Brandy Bonner[sup.2] , Caprice Knapp[sup.3] , Melissa Bright[sup.4] , Melanie Hinojosa[sup.5] Author Affiliations: (1) Department of Neurosurgery, University of Florida, PO Box 100265, 32611, Gainesville, FL, [...]