How we raise young children is one of today's most highly personalized and sharply politicized issues, in part because each of us can claim some level of "expertise." The debate has intensified as discoveries about our development-in the womb and in the first months and years-have reached the popular media. How can we use our burgeoning knowledge to assure the well-being of all young children, for their own sake as well as for the sake of our nation? Drawing from new findings, this book presents important conclusions about nature-versus-nurture, the impact of being born into a working family, the effect of politics on programs for children, the costs and benefits of intervention, and other issues. The committee issues a series of challenges to decision makers regarding the quality of child care, issues of racial and ethnic diversity, the integration of children's cognitive and emotional development, and more. Authoritative yet accessible, From Neurons to Neighborhoods presents the evidence about "brain wiring" and how kids learn to speak, think, and regulate their behavior. It examines the effect of the climate-family, child care, community-within which the child grows.

/pdf/from-neurons-to-neighborhoods-the-science-of-early-childhood-3bfl5g72ow.pdf

From Neurons to Neighborhoods: The Science of Early Childhood Development

OBJECTIVE — To systematically review the incidence of posttransplantation diabetes (PTD), risk factors for its development, prognostic implications, and optimal management. RESEARCH DESIGN AND METHODS — We searched databases (MEDLINE, EMBASE, the Cochrane Library, and others) from inception to September 2000, reviewed bibliographies in reports retrieved, contacted transplantation experts, and reviewed specialty journals. Two reviewers independently determined report inclusion (original studies, in all languages, of PTD in adults with no history of diabetes before transplantation), assessed study methods, and extracted data using a standardized form. Meta-regression was used to explain between-study differences in incidence. RESULTS — Nineteen studies with 3,611 patients were included. The 12-month cumulative incidence of PTD is lower (10% in most studies) than it was 3 decades ago. The type of immunosuppression explained 74% of the variability in incidence (P 0.0004). Risk factors were patient age, nonwhite ethnicity, glucocorticoid treatment for rejection, and immunosuppression with high-dose cyclosporine and tacrolimus. PTD was associated with decreased graft and patient survival in earlier studies; later studies showed improved outcomes. Randomized trials of treatment regimens have not been conducted. CONCLUSIONS — Physicians should consider modification of immunosuppressive regimens to decrease the risk of PTD in high-risk transplant recipients. Randomized trials are needed to evaluate the use of oral glucose-lowering agents in transplant recipients, paying particular attention to interactions with immunosuppressive drugs. Diabetes Care 25:583–592, 2002

A systematic review of the literature

Researchers and program developers in medical education presently face the challenge of implementing and evaluating curricula that teach medical students and house staff how to effectively and respect- fully deliver health care to the increasingly diverse populations of the United States. Inherent in this challenge is clearly defining educational and training outcomes consistent with this imperative. The traditional notion of competence in clinical training as a detached mastery of a theoretically finite body of knowledge may not be appropriate for this area of physician education. Cultural humility is proposed as a more suitable goal in multicultural medical education. Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partner- ships with communities on behalf of individuals and defined populations.

Cultural Humility Versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education

A rating scale for drug-induced akathisia has been derived that incorporates diagnostic criteria for pseudoakathisia, and mild, moderate, and severe akathisia. It comprises items for rating the observable, restless movements which characterise the condition, the subjective awareness of restlessness, and any distress associated with the akathisia. In addition, there is an item for rating global severity. A standard examination procedure is recommended. The inter-rater reliability for the scale items (Cohen's kappa) ranged from 0.738 to 0.955. Akathisia was found in eight of 42 schizophrenic in-patients, and nine had pseudoakathisia, where the typical sense of inner restlessness was not reported.

A rating scale for drug-induced akathisia

https://onlinelibrary.wiley.com/doi/pdf/10.1002/j.2051-5545.2011.tb00014.x

Physical illness in patients with severe mental disorders.I. Prevalence, impact of medications and disparities in health care

ContextRefugees experience multiple traumatic events and have significant associated
health problems, but data about refugee trauma and health status are often
conflicting and difficult to interpret.ObjectivesTo assess the characteristics of the literature on refugee trauma and
health, to identify and evaluate instruments used to measure refugee trauma
and health status, and to recommend improvements.Data SourcesMEDLINE, PsychInfo, Health and PsychoSocial Instruments, CINAHL, and
Cochrane Systematic Reviews (searched through OVID from the inception of each
database to October 2001), and the New Mexico Refugee Project database.Study SelectionKey terms and combination operators were applied to identify English-language
publications evaluating measurement of refugee trauma and/or health status.Data ExtractionInformation extracted for each article included author; year of publication;
primary focus; type (empirical, review, or descriptive); and type/name and
properties of instrument(s) included. Articles were excluded from further
analyses if they were review or descriptive, were not primarily about refugee
health status or trauma, or were only about infectious diseases. Instruments
were then evaluated according to 5 criteria (purpose, construct definition,
design, developmental process, reliability and validity) as described in the
published literature.Data SynthesisOf 394 publications identified, 183 were included for further analyses
of their characteristics; 91 (49.7%) included quantitative data but did not
evaluate measurement properties of instruments used in refugee research, 78
(42.6%) reported on statistical relationships between measures (presuming
validity), and 14 (7.7%) were only about statistical properties of instruments.
In these 183 publications, 125 different instruments were used; of these,
12 were developed in refugee research. None of these instruments fully met
all 5 evaluation criteria, 3 met 4 criteria, and 5 met only 1 of the criteria.
Another 8 standard instruments were designed and developed in nonrefugee populations
but adapted for use in refugee research; of these, 2 met all 5 criteria and
6 met 4 criteria.ConclusionsThe majority of articles about refugee trauma or health are either descriptive
or include quantitative data from instruments that have limited or untested
validity and reliability in refugees. Primary limitations to accurate measurement
in refugee research are the lack of theoretical bases to instruments and inattention
to using and reporting sound measurement principles.

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=JAMA&articleId=195170&pdfFileName=jrv20018.pdf

Measuring Trauma and Health Status in Refugees: A Critical Review

Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry

Growing Up American: How Vietnamese Children Adapt to Life in the United States.

Objectives. This cross-sectional, community-based, epidemiological study characterized Somali and Ethiopian (Oromo) refugees in Minnesota to determine torture prevalence and associated problems. Methods. A comprehensive questionnaire was developed, then administered by trained ethnic interviewers to a nonprobability sample of 1134. Measures assessed torture techniques; traumatic events; and social, physical, and psychological problems, including posttraumatic stress symptoms. Results. Torture prevalence ranged from 25% to 69% by ethnicity and gender, higher than usually reported. Unexpectedly, women were tortured as often as men. Torture survivors had more health problems, including posttraumatic stress. Conclusions. This study highlights the need to recognize torture in African refugees, especially women, identify indicators of posttraumatic stress in torture survivors, and provide additional resources to care for tortured refugees.

Somali and Oromo Refugees: Correlates of Torture and Trauma History

A vision into the roaring 1920‟s, Fitzgerald captures the decades indulgences. The novel is written through the eyes of a man named Nick Carraway. This fellow is an outsider who, for a summer, experiences the grandeur and glamour of New York. The protagonist, Gatsby, is his neighbor and seems to be a member of the quintessential 1920‟s. His parties are the talk of the town, though he is not throwing them for enjoyment. The reason for the parties is an integral part of the romantic theme throughout the book. Juxtaposed to these parties is is his wealth, which make them possible, but seems to be ill gotten. Ultimately the contention that comes from money, love, and power result in terrible deaths.

Joseph Westermeyer

Papers

Measuring Trauma and Health Status in Refugees: A Critical Review

Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry

Growing Up American: How Vietnamese Children Adapt to Life in the United States.

Somali and Oromo Refugees: Correlates of Torture and Trauma History

The Great Gatsbyby F. Scott Fitzgerald. New York, Scribner, 2004, 192 pp., $14.00.