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Multiple myeloma (MM) remains incurable. Although early diagnosis improves outcomes, it has been unclear which populations to target for screening with serum electrophoresis, serum free light chains and urine electrophoresis. Here, we assessed the value of MM screening in a Fracture Liaison Service, finding that 1 per 195 fragility fractures has undiagnosed MM, which can be expedited to Haematology Services. Purpose A key role of the Fracture Liaison Service (FLS) is screening for secondary causes of osteoporosis. In 2019, the Royal Osteoporosis Society recommended that all patients attending FLS who are recommended anti-osteoporosis therapy have universal screening for myeloma based on serum electrophoresis, serum free light chains and urine electrophoresis. Here, we examined the impact of universal myeloma screening within an FLS. Methods We sampled all patients seen by the Oxfordshire FLS between January and April 2018. The completion rates and outcomes of screening were checked using the hospital and FLS databases. Results Of 950 patients identified by the FLS, 628 were eligible for MM screening; 473 (75%) of these were female, and the average age was 78.4 years. Overall, 584 had some form of myeloma screening, of which 577 (92%) had serum electrophoresis, 525 (84%) had serum free light chains and 407 (65%) had urine electrophoresis measured. A total of 327 (59%) patients had complete screening. Three patients (0.5%) had newly diagnosed myeloma and were urgently referred to Haematology Services. Furthermore, 46 (8%) patients had a detectable serum paraprotein with a likely diagnosis of monoclonal gammopathy of uncertain significance (MGUS) and referred for community annual surveillance according to local guidelines. Conclusion Addition of universal myeloma screening to laboratory testing identified myeloma in 1 per 195 patients, and its precursor state MGUS in 1 per 13 patients, which may have otherwise been missed. Further analysis with long-term follow-up is needed to clearly define the value of diagnosing MGUS within the FLS setting and establish the benefits vs. costs and methods to improve screening completion rates.

Purpose Safe swallowing requires adequate protection of the airway to prevent swallowed materials from entering the trachea or lungs (i.e., aspiration). Laryngeal vestibule closure (LVC) is the first line of defense against swallowed materials entering the airway. Absent LVC or mistimed/shortened closure duration can lead to aspiration, adverse medical consequences, and even death. LVC mechanisms can be judged commonly through the videofluoroscopic swallowing study; however, this type of instrumentation exposes patients to radiation and is not available or acceptable to all patients. There is growing interest in noninvasive methods to assess/monitor swallow physiology. In this study, we hypothesized that our noninvasive sensor-based system, which has been shown to accurately track hyoid displacement and upper esophageal sphincter opening duration during swallowing, could predict laryngeal vestibule status, including the onset of LVC and the onset of laryngeal vestibule reopening, in real time and estimate the closure duration with a comparable degree of accuracy as trained human raters. Method The sensor-based system used in this study is high-resolution cervical auscultation (HRCA). Advanced machine learning techniques enable HRCA signal analysis through feature extraction and complex algorithms. A deep learning model was developed with a data set of 588 swallows from 120 patients with suspected dysphagia and further tested on 45 swallows from 16 healthy participants. Results The new technique achieved an overall mean accuracy of 74.90% and 75.48% for the two data sets, respectively, in distinguishing LVC status. Closure duration ratios between automated and gold-standard human judgment of LVC duration were 1.13 for the patient data set and 0.93 for the healthy participant data set. Conclusions This study found that HRCA signal analysis using advanced machine learning techniques can effectively predict laryngeal vestibule status (closure or opening) and further estimate LVC duration. HRCA is potentially a noninvasive tool to estimate LVC duration for diagnostic and biofeedback purposes without X-ray imaging.

PurposeThe purpose of this study is to validate the Matten and Moon (2008) implicit-explicit corporate social responsibility (CSR) model by examining whether the respective differences in CSR practices between Europe and the USA reflect their respective societal expectations.Design/methodology/approachThe principal component analysis is used to develop an innovative societal expectations index (SEI). This study tests the relationship between SEI and CSR through panel data andt-tests.FindingsThe empirical findings show a significant association between the SEI and all forms of CSR, which provides empirical support for Matten’s and Moon’s implicit-explicit framework.Originality/valueThis study is the first to develop an SEI to validate the Matten and Moon (2008) model that predicts implicit countries would adopt and conform to broader societal expectations for CSR, and therefore be more likely to embrace CSR activities than their counterparts in explicit countries.

Clinicians and researchers commonly judge the completeness of hyoid displacement from videofluoroscopic swallow study (VFSS) videos. Judgments made during the clinical exam are often subjective, and post-examination analysis reduces the measure's immediate value. This study aimed to determine the validity and feasibility of a visual, anatomically scaled benchmark for judging complete hyoid displacement during a VFSS. The third and fourth cervical vertebral bodies (C3 and C4) lie at roughly the same vertical position as the hyoid body and are strongly correlated with patient height. We hypothesized that anterior and superior displacement of the hyoid bone would approximate the height of one C3 or C4 body during safe swallows. Trained raters marked points of interest on C3, C4, and the hyoid body on 1414 swallows of adult patients with suspected dysphagia (n = 195) and 50 swallows of age-matched healthy participants (n = 17), and rated Penetration Aspiration Scale scores. Results indicated that the mean displacements of the hyoid bone were greater than one C3 unit in the superior direction for all swallows from patient and healthy participants, though significantly and clinically greater in healthy participant swallows (p .001, d .8). The mean anterior and superior displacements from patient and healthy participant swallows were greater than one C4 unit. Results show preliminary evidence that use of the C3 and/or C4 anatomic scalars can add interpretive value to the immediate judgment of hyoid displacement during the conduct of a clinical VFSS examination.

This research is one of the first studies to examine the effects of CSR disclosures on a firm’s decision to purchase back their own shares of stocks. Additionally, the authors examine whether the effect of CSR disclosures is stronger than the effect of CSR performance on the decision to repurchase shares. Examining firms in the United States, the authors find that total CSR disclosures and the CSR disclosures related to the dimensions of social, environmental, and governance are significantly and positively related to the number of shares that a firm buys back. Additionally, the authors find that the effects of CSR disclosures are stronger for total and the CSR dimensions of social and governance than for CSR performance. For the environmental dimension of CSR, both disclosure and performance scores are significant. This research expands our understanding of the impact of CSR disclosure by showing the importance it plays in the decision to buy back stock and implies that firms that repurchase their stock are more socially responsive than firms that do not. Finally, it contributes to the growing literature on how CSR disclosure has a different impact than CSR performance on firm decisions and outcomes.

Multiple myeloma (MM) remains incurable. Although early diagnosis improves outcomes, it has been unclear which populations to target for screening with serum electrophoresis, serum free light chains and urine electrophoresis. Here, we assessed the value of MM screening in a Fracture Liaison Service, finding that 1 per 195 fragility fractures has undiagnosed MM, which can be expedited to Haematology Services.A key role of the Fracture Liaison Service (FLS) is screening for secondary causes of osteoporosis. In 2019, the Royal Osteoporosis Society recommended that all patients attending FLS who are recommended anti-osteoporosis therapy have universal screening for myeloma based on serum electrophoresis, serum free light chains and urine electrophoresis. Here, we examined the impact of universal myeloma screening within an FLS.We sampled all patients seen by the Oxfordshire FLS between January and April 2018. The completion rates and outcomes of screening were checked using the hospital and FLS databases.Of 950 patients identified by the FLS, 628 were eligible for MM screening; 473 (75%) of these were female, and the average age was 78.4 years. Overall, 584 had some form of myeloma screening, of which 577 (92%) had serum electrophoresis, 525 (84%) had serum free light chains and 407 (65%) had urine electrophoresis measured. A total of 327 (59%) patients had complete screening. Three patients (0.5%) had newly diagnosed myeloma and were urgently referred to Haematology Services. Furthermore, 46 (8%) patients had a detectable serum paraprotein with a likely diagnosis of monoclonal gammopathy of uncertain significance (MGUS) and referred for community annual surveillance according to local guidelines.Addition of universal myeloma screening to laboratory testing identified myeloma in 1 per 195 patients, and its precursor state MGUS in 1 per 13 patients, which may have otherwise been missed. Further analysis with long-term follow-up is needed to clearly define the value of diagnosing MGUS within the FLS setting and establish the benefits vs. costs and methods to improve screening completion rates.

Recent publications have suggested that high-resolution cervical auscultation (HRCA) signals may provide an alternative non-invasive option for swallowing assessment. However, the relationship between hyoid bone displacement, a key component to safe swallowing, and HRCA signals is not thoroughly understood. Therefore, in this work we investigated the hypothesis that a strong relationship exists between hyoid displacement and HRCA signals. Videofuoroscopy data was collected for 129 swallows, simultaneously with vibratory/acoustic signals. Horizontal, vertical and hypotenuse displacements of the hyoid bone were measured through manual expert analysis of videofluoroscopy images. Our results showed that the vertical displacement of both the anterior and posterior landmarks of the hyoid bone was strongly associated with the Lempel-Ziv complexity of superior-inferior and anterior-posterior vibrations from HRCA signals. Horizontal and hypotenuse displacements of the posterior aspect of the hyoid bone were strongly associated with the standard deviation of swallowing sounds. Medial-Lateral vibrations and patient characteristics such as age, sex, and history of stroke were not significantly associated with the hyoid bone displacement. The results imply that some vibratory/acoustic features extracted from HRCA recordings can provide information about the magnitude and direction of hyoid bone displacement. These results provide additional support for using HRCA as a non-invasive tool to assess physiological aspects of swallowing such as the hyoid bone displacement.

PurposeAlthough most corporate directors face reelection by shareholders each year, directors of companies with classified boards are elected for multiple-year terms. Classified boards may engender managerial entrenchment, which may make directors less responsive to shareholders’ interest in corporate social responsibility (CSR). Alternatively, classified boards may engender a longer-term focus, which could make the board more willing to engage in projects with longer-term benefits, such as CSR. This study aims to assess whether larger boards, with potentially more diverse voices, may be positively related to CSR, and a larger board may change the classified boards/CSR relationship.Design/method/approachThe authors examine the relationship between board type (companies with and without classified boards), board size and CSR for 4,489 firm-years (1,540 with classified boards and 2,949 without classified boards) from 2013 through 2015.FindingsThe authors find no difference in CSR strengths between companies with and without classified boards, but the authors do find that companies with classified boards have more CSR concerns than companies without classified boards. For all types of boards, a larger board size is associated with more CSR strengths and reduces the negative impact of having a classified board on CSR concerns.Practical implicationsClassified boards may be less responsive to shareholders’ preference for reduced company CSR concerns, but an increase in board size can mitigate this effect.Social implicationsClassified boards may weaken a company’s CSR performance.Originality/valueThis is the first paper to consider the relationship between classified board and CSR.

We examined the relationship between Corporate Social Responsibility (CSR) and director characteristics, including director gender and director role. Directors can have different roles on t...

Infants born prematurely or with complex medical conditions often require treatment to facilitate safe and efficient feeding. Practice is based on evidence, so frontline clinicians look to the literature to make informed clinical decisions. The aim of this scoping review was to map and describe the literature base for infant feeding and swallowing interventions and to identify areas for further research. Four electronic databases were searched from the sources' inceptions through April 2020 using a search strategy designed by a health sciences research librarian. Thirteen grey literature sources were searched and forward and backward citation chasing was performed. Inclusion criteria were English-language studies reporting non-pharmacological and non-surgical interventions for hospitalized infants. Exclusion criteria included interventions exclusively for infants with cleft lip or palate or for infants being fed exclusively though enteral feeding. Data were extracted using a form created a priori and data were reported descriptively. We reviewed 6654 abstracts: 725 were chosen for full-text review and 136 met inclusion. Most studies explored interventions for infants born prematurely (n = 128). Studies were stratified by intervention domain: bridging (n = 91) and feeding/swallowing (n = 45); intervention approach: direct (n = 72), indirect (n = 31), or combination (n = 33); and outcome: feeding performance (n = 125), physiologic stability (n = 40), and swallowing physiology (n = 12). The body of research in infant feeding has grown; however, a need remains for research focused on populations of infants with various medical complexities and for frequently used interventions that lack supporting evidence.

Few studies have examined clinical signs of aspiration in infants51 weeks post-menstrual age (PMA) for whom the laryngeal cough reflex is not fully developed. This retrospective study explored 1) the association between signs of aspiration on a clinical feeding evaluation (CFE) and/or comorbid conditions with aspiration (silent or overt) on a modified barium swallow study (MBS) for infants in this age range, 2) the association between lower respiratory infection (LRI) and aspiration on MBS, and 3) the sensitivity and specificity of detecting aspiration according to signs on CFE and the evaluating speech-language pathologist's (SLP) years of experience.A retrospective review of charts of patients with MBS completed January 1, 2012-December 31, 2014 was performed. Patients were included if they were51-weeks PMA at the time of MBS and had a CFE conducted no more than seven days prior to the MBS. Patient age, comorbidities, and MBS and CFE details were collected. The impact of CFE findings, patient age, comorbid syndromes/associations, and aerodigestive diagnoses on the odds of demonstrating silent aspiration (SA) or overt aspiration during MBS with thin liquids was determined using logistic regression, and the sensitivity and specificity of CFE for identifying SA was calculated.Results from 114 patients indicated that 46 (40 %) of the infants had SA and nine (8 %) had overt aspiration on MBS. Notable signs on CFEs were cough (36 %), oxygen desaturations (33 %), and chest congestion (32 %). On multiple regression analysis there was increased odds of SA on MBS with at least one clinical sign on CFE (OR: 24.3, p = 0.02), chronic lung disease, (OR: 18.2, p = 0.01), and airway abnormalities (OR: 2.94, p = 0.01). Cough on CFE was associated with increased odds of overt aspiration on MBS (OR: 5.69, p = 0.04). Neither SA nor overt aspiration were significantly associated with LRI. Sensitivity and specificity of CFE for correctly identifying the presence of SA were 98 % and 15 %, respectively; experience of the SLP was not a contributing factor.Further study is required to determine if specific signs on CFE are predictive of aspiration.

Dysphagia management, from screening procedures to diagnostic methods and therapeutic approaches, is about to change dramatically. This change is prompted not solely by great discoveries in medicine or physiology, but by advances in electronics and data science and close collaboration and cross-pollination between these two disciplines. In this editorial, we will provide a brief overview of the role of artificial intelligence in dysphagia management.

Tracking a liquid or food bolus in videofluoroscopic images during X-ray based diagnostic swallowing examinations is a dominant clinical approach to assess human swallowing function during oral, pharyngeal and esophageal stages of swallowing. This tracking represents a highly challenging problem for clinicians as swallowing is a rapid action. Therefore, we developed a computer-aided method to automate bolus detection and tracking in order to alleviate issues associated with human factors. Specifically, we applied a stateof-the-art deep learning model called Mask-RCNN to detect and segment the bolus in videofluoroscopic image sequences. We trained the algorithm with 450 swallow videos and evaluated with an independent dataset of 50 videos. The algorithm was able to detect and segment the bolus with a mean average precision of 0.49 and an intersection of union of 0.71. The proposed method indicated robust detection results that can help to improve the speed and accuracy of a clinical decisionmaking process.

When making investment decisions, many investors now regularly consider a company’s CSR activities along with traditional financial performance measures (Elliott et al., 2014). Our study considers whether shareholders may also consider CSR activities when voting in director elections and say-on-pay votes. We find that CSR performance is associated with shareholder support in both director elections and say-on-pay votes. In particular, we find higher support for both director elections and executive compensation when there are more CSR strengths. Additionally, we find that the social strength aspect of CSR is the most important component in the relationships between CSR and director elections and that the environmental strengths aspect is the most important component in the relationship between CSR and executive compensation. Our results suggest that shareholders may value certain types of CSR and are more supportive of boards and management when CSR performance is stronger.

Developmental trajectories of children's pretend play and social engagement, as well as parent sensitivity and stimulation, were examined in toddlers with an older sibling with autism spectrum disorder (ASD, high risk; HR) and toddlers with typically-developing older siblings (low risk; LR). Children (N = 168, 97 boys, 71 girls) were observed at 22, 28, and 34 months during free play with a parent and elicited pretend play with an examiner. At 28 and 34 months, children were asked to imagine the consequences of actions pantomimed by the examiner on a pretend transformation task. At 36 months children were assessed for ASD, yielding 3 groups for comparison: HR children with ASD, HR children without ASD (HR-noASD), and LR children. Children in all 3 groups showed developmental changes, engaging in more bouts of pretend play and obtaining higher scores on the elicited pretend and transformation tasks with age, but children with ASD lagged behind the other 2 groups on most measures. Children with ASD were also less engaged with their parents or the examiner during play interactions than either LR or HR-noASD children, with minimal developmental change evident. Parents, regardless of group, were highly engaged with their children, but parents of HR-noASD children received somewhat higher ratings on stimulation than parents of LR children. Most group differences were not accounted for by cognitive functioning. Instead, lower social engagement appears to be an important correlate of less advanced pretend skills, with implications for understanding the early development of children with ASD and for early intervention.

Parents of toddlers with an older sibling with autism spectrum disorder (ASD; high risk, HR) and parents of low risk (LR) toddlers with typically-developing older siblings read a wordless picture book to their child at 22 and 28 months. Parents’ and toddlers’ internal state language (ISL) was coded; parents reported on toddlers’ use of ISL. Diagnostic assessments conducted at 36 months identified three groups: ASD, HR-noASD, LR. Parents did not differ in overall ISL, but parents of toddlers with later ASD attempted to elicit ISL from their children less than parents of LR toddlers. Toddlers increased their use of ISL with age, but those with ASD had lower scores and less age-related improvement than children in the other two groups.

Videofluoroscopic swallow studies are widely used in clinical and research settings to assess swallow function and to determine physiological impairments, diet recommendations, and treatment goals for people with dysphagia. Videofluoroscopy can be used to analyze biomechanical events of swallowing, including hyoid bone displacement, to differentiate between normal and disordered swallow functions. Previous research has found significant associations between hyoid bone displacement and penetration/aspiration during swallowing, but the predictive value of hyoid bone displacement during swallowing has not been explored. The primary objective of this study was to build a model based on aspects of hyoid bone displacement during swallowing to predict the extent of airway penetration or aspiration during swallowing. Aspects of hyoid bone displacement from 1433 swallows from patients referred for videofluoroscopy were analyzed to determine which aspects predicted risk of penetration and aspiration according to the Penetration-Aspiration Scale. A generalized estimating equation incorporating components of hyoid bone displacement and variables shown to impact penetration and aspiration (such as age, bolus volume, and viscosity) was used to evaluate penetration and aspiration risk. Results indicated that anterior-horizontal hyoid bone displacement was the only aspect of hyoid bone displacement predictive of penetration and aspiration risk. Further research should focus on improving the model performance by identifying additional physiological swallowing events that predict penetration and aspiration risk. The model built for this study, and future modified models, will be beneficial for clinicians to use in the assessment and treatment of people with dysphagia, and for potentially tracking improvement in hyolaryngeal excursion resulting from dysphagia treatment, thus mitigating adverse outcomes that can occur secondary to dysphagia.

Purpose This paper examines whether shareholders consider corporate social responsibility (CSR) performance when voting on corporate governance change proposals submitted by dissident shareholders. These proposals recommend changes to the corporate governance status quo and are made by dissident shareholders who are dissatisfied with the company’s existing governance practices. Design/methodology/approach Using 195 governance change proposals voted on during 2013, the paper examines the relationship between CSR performance (obtained from the MSCI database) and the level of voting support for these proposals. Findings This study finds that shareholder support for corporate governance change proposals submitted by dissident shareholders is positively related to firms’ CSR concerns, especially environmental concerns. Research limitations/implications The findings suggest that shareholders may be concerned with the potentially adverse effects of weak CSR performance, especially poor environmental performance, and may support changes to corporate governance structures when a company’s CSR and environmental performance is weaker. Originality/value As the first research to examine the relationship between CSR and proposed changes to corporate governance, this study provides unique insights into shareholder perceptions of the value of CSR based on shareholders’ support (or lack thereof) for governance changes proposed by dissident shareholders.

Background: In 2015, the Co-Chairs and Steering Committee of the Research Council members recognized the need to reevaluate the council’s priorities. Objective: To determine the top priorities for the Research Council. Design: Use of liberating structures: Impromptu Speed Networking, 1-2-4-all, and Crowd Sourcing. Results: Identified Research Council priorities included the following: efforts to increase psychiatric mental health (PMH) research funding; serve as a connector to bring researchers together; foster research through state chapters; increase collaboration between PhDs and DNPs; and develop models for organizational support for PMH staff nurse involvement in research. Conclusions: The liberating structures used are valuable strategies for engaging groups of people to identify what matters most to the group. Through the use of these novel techniques, the American Psychiatric Nurses Association Research Council has identified priorities for the work of the council. This has led to actions planned for the coming future with the intent to move PMH nursing research forward.

Psychiatric nurse executives and managers face an ongoing challenge to create positive professional work environments that support the recruitment and retention of the best nurses. The Pathway to Excellence program is an organizational credentialing program that designates a hospital as a workplace of choice for nursing. This article describes one psychiatric hospital's journey to become and maintain a Pathway to Excellence designation in the midst of transition. Challenges faced and novel approaches used, along the journey, are shared. The use of Appreciative Inquiry techniques has led to positive changes and heightened energy among nurses. Our experiences suggest that effective shared governance is central to a hospital's Pathway to Excellence success. We attribute the steady increase in the retention rate of nurses, in large part, to the Pathway to Excellence program.

We explore how societies convince citizens to “go to hell,” where they kill strangers and risk their own lives. Our premise is that killing is difficult for most, regardless of context and widely considered a form of extreme deviance. Using Sykes and Matza’s techniques of neutralization, we show how this aversion to killing is neutralized by placing individuals in organized—both macro-level bureaucratic and micro-level small primary groups—to justify killing. Consequently, the neutralization of mass killing illustrates the role of power in defining deviance, and the failure of neutralizations may sometimes explain Post-Traumatic Stress Disorder.

Infants

We examine the perceived influence of externally generated firm ratings of corporate social responsibility (CSR) on voting for shareholder-sponsored CSR proposals. Using stakeholder and legitimacy theories, we introduce two rationales that relate shareholder voting decisions to the firm’s CSR performance: the complementary perspective where investors rely on management’s branding or image of the firm for CSR performance, and the sufficiency perspective where shareholders consider legitimacy effects of firm CSR performance. Our examination of 473 CSR shareholder-sponsored proposals during the 2013 to 2015 proxy seasons reveals a negative relationship between support for shareholder-sponsored CSR proposals and CSR strengths, particularly for social and environmental CSR strengths. We also find a positive relationship between support for shareholder-sponsored CSR proposals and CSR concerns, particular in the area of environmental CSR concerns. These results partially support the sufficiency perspective that incorporates shareholder legitimacy concerns. When companies have poor CSR performance, shareholders may view further CSR initiatives as beneficial to the firm.

We considered the question of how corporate social responsibility (CSR) differs between Canada and the U.S. Prior research has identified that national institutional differences exist between the two countries [Freeman and Hasnaoui, J Business Ethics 100(3):419–443, 2011], which may be associated with variations in their respective CSR practices. Matten and Moon [Acad Manag Rev 33(2):404–424, 2008] suggested that cross-national differences in firms’ CSR are depicted by an implicit–explicit conceptual framework: explicit CSR practices are deliberate and more strategic than implicit CSR practices. We compared Canada and U.S. CSR and examined how CSR strategic alliances, CSR reporting, and CSR performance in the two countries correspond to implicit versus explicit CSR practices, which we link to stakeholder and signaling perspectives. We relied upon a new database, the Sustainalytics Global Platform (SGP), and we found a positive association exists between CSR strategic alliances and the number of years that firms have issued standalone CSR reports in both countries. Moreover, we found that CSR scores mediated this association in the U.S., as U.S. firms with high CSR scores typically engage in more CSR strategic alliances. In Canada, we did not find this mediating effect. Our findings suggest that U.S. firms engage in signaling activities that are more strategic and explicit than their Canadian counterparts. This paper closes with implications for practice and theory.

OBJECTIVE This study examined changes in health-related quality of life in adult inpatients with serious mental illness engaged in a 6- to 8-week intensive treatment program. METHOD Admission and discharge assessment with the MOS 36-item Short-Form Health Survey was completed (June 2010-June 2012) for 410 adults aged 18-68 years. Paired t tests and effect size estimates were calculated for the overall sample, and reliable change index scores and clinical significance were calculated to estimate individual-level response and recovery rates. Hierarchical stepwise regression analyses were conducted to explore patient pretreatment characteristics, including total number of DSM-IV-TR diagnoses, that influence treatment response. RESULTS Large effect size improvements were demonstrated for the Mental Component Summary score (Cohen d = 1.5), including subjective ratings of vitality (Cohen d = 1.1), social functioning (Cohen d = 1.3), role-emotional functioning (Cohen d = 1.3), and mental health (Cohen d = 1.3). Equivocal findings for change in physical health were demonstrated, with the majority of patients demonstrating no significant change in function (t409 = 0.14, P = .89) but approximately equal numbers of patients demonstrating improvement and deterioration. The pretreatment characteristic of a tendency to be interpersonally distant, cold, and disengaged was predictive of a poorer outcome on Mental Component Summary treatment response (P < .001). CONCLUSIONS In light of a heavy burden of illness and high psychiatric comorbidity of this sample, treatment response was generally positive for improvement in mental health functioning. This study adds to a growing body of evidence indicating robust treatment response even for those with serious mental illness when treatment is intensive and multimodal.

This chapter examines the images of crime and race presented in one such program, "Cops". This show was chosen because it is one of the most popular of its genre according to Nielsen ratings, is frequently aired, and is one of the oldest and probably best known of the reality-based crime shows on television. The chapter scrutinizes the types and social dynamics of crimes portrayed. It analyses the world of crime found on "Cops" with that described in the Uniform Crime Reports for 1994. The chapter examines the types of crimes portrayed, the racial composition of the actors involved, and the outcomes (e.g., arrested or not arrested). It also analyses the dynamics of crime; that is, what relationships are shown between victims and offenders, and what types of crimes are associated with which types of offenders. The chapter also examined whether there were differences in the types of crimes committed on "Cops" by differing race.

Archaeological sites involving African American history and life often remain un-interpreted or are poorly interpreted because it can be difficult for Americans to confront a deeply painful history of enslavement, racism, segregation, exploitation of labour, disenfranchisement, and displacement. In this article, I discuss specific case studies of archaeological sites representative of great injustices in American history and efforts to present these events, and the people who lived through them, through public interpretation.

In the past decade a new form of television programming has emerged, startled into existence primarily by Rupert Murdoch’s Fox Broadcasting Company. Sex and violence in scandalous proportions were served up in an effort to launch a fourth TV network made up of independent stations. The heart of this format included video news magazines such as “A Current Affair” and crime shows such as “Cops” and “America’s Most Wanted.” These shows were quickly imitated by other networks because of their profitability and popularity. They were relatively inexpensive to produce and attracted reasonable audience interest at the time slots into which they were placed (Fennell 1992; Sauter 1992). Soon the airwaves were inundated with reality-based police shows such as “American Detective,” “Top Cops,” and “True Stories of the Highway Patrol.” Other news magazines such as “Hard Copy” made frequent use of the same common themes utilized by “A Current Affair”—sordid sex crimes and bloody murders.

In an era of health care that is driven by biological and technical advances, there is a need to safeguard the caring component of care, the humanistic part of care. With this in mind, the authors constructed a Patient-Centered Caring model consisting of three overlapping constructs: delivering customer service, understanding the illness experience, and providing trauma-informed care. These practices operate within an interprofessional competency context. The authors describe an interprofessional educational project focused on understanding the illness experience and providing trauma-informed care to faculty, staff, and administrators in an inpatient psychiatric setting. The authors discuss the project through a number of ethical lenses that may help explicate the ethics of patient-centered care and caring and can be useful in the development of interprofessional competence.