Seventy-six percent of 65 psychotherapy cases seen in a child guidance clinic either did not change or improved following a mandated report of suspected child abuse. In a significant minority of cases, the therapy relationship deteriorated when the report was made about a client in treatment, and improved when the report was made about a third party not in treatment.

Although patient satisfaction has been given considerable attention in health care, analysis of the conceptual and measurement limitations of existing measures indicates that a more elemental approach to obtaining patients' perspectives is warranted. In this investigation we developed and evaluated the psychometric properties of an instrument designed to measure patients' perceptions of the degree to which their needs were met while hospitalized. This 15-item instrument, Patient Perception of Hospital Experience with Nursing (PPHEN), based on Swanson-Kauffman's framework of caring, is internally consistent and represents a single construct best described as feeling cared for. The relationship of PPHEN to other measures demonstrates concurrent validity; moreover, the scale is responsive to differences in care provided, as shown by differences in means for different hospitals. PPHEN offers a brief, theoretically oriented, internally consistent, and valid patient self-report measure of nursing care. It does not require patients to compare their expectations of care with the care received but only to evaluate whether their needs were met. It promises to be useful to clinical and health services researchers.

In the face of a housing crisis rooted in commodification, there is growing alignment within both activist and scholarly circles over the need to reverse this trend and move toward decommodification. There is work left to be done, however, in conceptualizing how to get there. Housing and tenant groups challenge the logic of extraction through their day-to-day struggles in privately-held rental housing. The policy priorities of this movement are rooted in housing justice. By giving tenants more power over where they live through rent regulation, eviction protections, robust code enforcement, and other forms of legal recourse, these policies make real estate speculation less profitable. In parallel, there is a growing call for social housing conversions through both public takings and private land and property acquisition to realize a vision of housing that prioritizes decommodification, deep affordability, and democratic management. But how do these visions of housing decommodification relate to one another? In our forthcoming project Pathways to Social Housing in New York, we draw out connections between these different strategies, outlining a broad collection of policies that together can present a road to housing decommodification, both within our state and elsewhere around the country. In particular, we argue that to decommodify urban property, we need to fight not only for policy and funding which transfers land and housing to social ownership, but also for policies that make extractive and predatory housing models less viable and organizing more feasible. We need a strategy that incorporates both social housing and housing justice.

In her recent book The Warhol Economy, Elizabeth Currid proposes that -cultural economies operate differently from other industries‖ such as -finance, law and manufacturing‖ which tend towards a -formal, rigid‖ set of institutional arrangements. 1 While an agglomeration of firms and labour pools can be an asset in any industry, in the case of artistic and other types of cultural production, spatial proximity and face-to-face social interaction become the -decisive mechanism[s] by which cultural products and cultural producers are generated, evaluated and sent to the market.‖ 2 We see this, argues Currid, from the very different kinds of geographies occupied by creative-as against traditional-industries:

Although patient satisfaction has been given considerable attention in health care, analysis of the conceptual and measurement limitations of existing measures indicates that a more elemental approach to obtaining patients' perspectives is warranted. In this investigation we developed and evaluated the psychometric properties of an instrument designed to measure patients' perceptions of the degree to which their needs were met while hospitalized. This 15-item instrument, Patient Perception of Hospital Experience with Nursing (PPHEN), based on Swanson-Kauffman's framework of caring, is internally consistent and represents a single construct best described as feeling cared for. The relationship of PPHEN to other measures demonstrates concurrent validity; moreover, the scale is responsive to differences in care provided, as shown by differences in means for different hospitals. PPHEN offers a brief, theoretically oriented, internally consistent, and valid patient self-report measure of nursing care. It does not require patients to compare their expectations of care with the care received but only to evaluate whether their needs were met. It promises to be useful to clinical and health services researchers. ß

Although patient satisfaction has been given considerable attention in health care, analysis of the conceptual and measurement limitations of existing measures indicates that a more elemental approach to obtaining patients' perspectives is warranted. In this investigation we developed and evaluated the psychometric properties of an instrument designed to measure patients' perceptions of the degree to which their needs were met while hospitalized. This 15-item instrument, Patient Perception of Hospital Experience with Nursing (PPHEN), based on Swanson-Kauffman's framework of caring, is internally consistent and represents a single construct best described as feeling cared for. The relationship of PPHEN to other measures demonstrates concurrent validity; moreover, the scale is responsive to differences in care provided, as shown by differences in means for different hospitals. PPHEN offers a brief, theoretically oriented, internally consistent, and valid patient self-report measure of nursing care. It does not require patients to compare their expectations of care with the care received but only to evaluate whether their needs were met. It promises to be useful to clinical and health services researchers. ß

The host-feeding patterns of Anopheles quadrimaculatus Say and Anopheles punctipennis (Say) were examined in order to evaluate their potential contributions to the transmission of eastern equine encephalitis virus (EEEv) and other arboviruses in the northeastern U.S.A. Engorged mosquitoes of the two species were collected from EEEv foci in central New York (NY) and throughout New Jersey (NJ), and their bloodmeals were identified using a polymerase chain reaction (PCR)-based assay and sequencing portions of the mitochondrial cytochrome b gene. Analysis of 131 An. quadrimaculatus and 107 An. punctipennis from NY revealed that 97.7% and 97.2%, respectively, had acquired blood solely from mammalian hosts. Similarly, examination of 288 An. quadrimaculatus and 127 An. punctipennis from NJ showed 100% and 96.0%, respectively, contained mammalian-derived bloodmeals. Mosquitoes containing mixed bloodmeals from both avian and mammalian hosts were detected in 1.6% of An. quadrimaculatus from NY, and 2.8% and 4.0% of An. punctipennis from NY and NJ, respectively. White-tailed deer (Odocoileus virginianus) constituted the most common vertebrate host for these anopheline mosquitoes, accounting for 85.8-97.7% of all bloodmeals identified. The predominance of white-tailed deer as a source of bloodmeals supports enzootic amplification of deer-associated arboviruses in this region, including Jamestown Canyon, Cache Valley and Potosi viruses. One horse-and two human-derived bloodmeals were also detected in An. quadrimaculatus collected in NJ. Limited avian-derived bloodmeals were detected from mourning dove (Zenaida macroura), sharp-shinned hawk (Accipiter striatus) and house finch (Carpodacus mexicanus), mostly in mixed bloodmeals. Occasional feeding on avian hosts suggests that these mosquitoes may participate as epizootic-epidemic bridge vectors of EEEv from viraemic birds to mammalian hosts of concern, including horses and humans. An isolate of EEEv was recovered from the head and thorax of an An. punctipennis mosquito collected in NY.

Municipal solid waste generation is a rapidly increasing challenge that is leading to severe pollution and environmental degradation in many urban areas of developing countries. Globally, the solid waste sector accounts for 18% of methane emissions and 3e4% of greenhouse gas emissions overall. Waste handling and disposal systems in most large cities have largely been designed with minimal accounting of environmental issues. This study presents the Waste to Energy Recovery Assessment (WERA) framework, a new quantitative decision support model for initial evaluation and alternative comparisons of different thermochemical treatments of municipal wastes. The framework not only accounts for benefits through electricity generation but also accounts for emissions from facilities and the associated social cost of carbon in a cost-benefit assessment. The assessments are conducted with Monte Carlo simulations that explicitly account for uncertain factors such as future composition and generation of solid waste, technical efficiency of treatment processes, capital and operating costs, as well as future policies. The framework is used to study waste-to-energy (WtE) systems for Abu Dhabi, Riyadh, Tokyo and New York. The results show that WtE systems can fulfill only 1.4e3.6% of 2014 electricity demand in the analyzed cases. Furthermore, the net present value for different technologies can be positive if collection fees and electricity rates (potentially set through feed-in-tariff policies) are sufficiently high. The analysis for Abu Dhabi and Riyadh also reveals that in a limited set of conditions (of technology efficiencies, and waste collection rates etc.) the WtE facilities can be self-sustaining investments.

Our country's rapidly growing older adult population represents the core business of health care; however, few nurses are adequately prepared to care for their unique needs. This is caused, in part, by the limited attention paid by nursing educators to incorporating basic gerontological nursing principles into undergraduate programs. During the last 7 years, the American Association of Colleges of Nursing, through the generous support of the John A. Hartford Foundation, has led several initiatives to improve gerontological nursing education in baccalaureate programs. This article describes innovative educational strategies successfully implemented by three nursing programs-New York University, Tuskegee University, and University of Rhode Island-to increase knowledge and improve attitudes of nursing students in caring for older adults. Successful strategies include a long-term care guide, a senior mentor experience, student assignments addressing diversity issues, student debates, critical reflective journalizing, and an evaluation tool for measuring student attitudes. These strategies are readily reproducible and assist faculty to easily integrate gerontological nursing content into the curriculum while simultaneously enhancing student attitudes and knowledge. (Index words: Student attitudes; Health care; Nursing education; Older adults) J Prof Nurs 22: 91-97, 2006.

o connect practices, outcomes, quality, value, T and costs, healthcare organizations must start using a balanced scorecard. A balanced scorecard is a set of measures that reveals the interdependency of the organization, its employees, and its patients. It thus serves as a balanced perspective on the organization for senior management to use in designing, developing, deploying, and directing the strategic plan, consistent with total quality management principles.

Activation of the emergency medical services (EMS) system does not always result in transport of a patient to the hospital. This study assessed the outcomes of patients who refused medical assistance in the field, to determine if refusal of medical assistance (RMA) is associated with poor outcomes. Four high-volume suburban volunteer ambulance corps participated in the study. Consecutive patients who refused medical assistance were prospectively enrolled, Medical and identifying data were collected for each patient. Telephone follow-up was conducted to determine the patient's condition and if the patient sought further care after RMA. Primary endpoints were whether the patient sought further care, was admitted to a hospital, or died subsequent to RMA. Follow-up was successfully obtained for 199 of 321 patients enrolled (62%). Of these 199 patients, 95 (48%) sought further medical care within 1 week for the same complaint, with 13 being admitted to the hospital. Six of the 13 admitted patients had chief complaints of a cardiac or respiratory nature. One patient died during hospital admission. Even if none of the patients lost to follow-up had sought further care, a substantial number of patients who refuse out-of-hospital medical assistance seek further care. Some of these patients require hospital admission, especially those with cardiac or respiratory complaints, Efforts to minimize RMA should be especially focused on patients with such complaints.

Artists and art communities are essential to the cultural life of cities. In New York City, artists have created networks of artist-run galleries in unlikely spaces that are outside the corporate gallery system. Sociologist Mary Kosut explores how artists generate alternative urban art economies within the contemporary New York art world.

Few studies of the prevalence of histologic lesions of the exocrine pancreas in dogs have been reported, and none of them systematically evaluate the localization of these lesions. The purpose of this study was to describe the anatomic localization of pancreatic inflammation, necrosis, and fibrosis in dogs presented for postmortem examination. Seventy-three pancreata from dogs presented for postmortem examination were evaluated and investigated for the presence of suppurative inflammation (SI), pancreatic necrosis (PN), and lymphocytic inflammation (LI). Sections that showed evidence of SI, PN, or LI also were evaluated for pancreatic fibrosis (F). The tendency for a preferred localization for SI, PN, and LI was evaluated by chi-square analysis. A total of 47 pancreata with histologic evidence of pancreatitis (SI, PN, or LI; F alone was not considered evidence of pancreatitis) were identified. Twenty-four (51.1%) had SI, 23 (48.9%) had PN, and 34 (72.3%) had LI. Of the 47 dogs with SI, PN, or LI, 28 (59.6%) had F. The distribution of SI, PN, and LI between the right and the left limb of the pancreas and among the 5 anatomic regions was random, based on a goodness-of-fit test. We conclude that pancreatic inflammation tends to occur in discrete areas within the pancreas rather than diffusely throughout the whole organ. These findings suggest that a single biopsy is insufficient to exclude subclinical pancreatitis and that there is no preferred site for pancreatic biopsy collection unless gross lesions are apparent.

Objective: To test whether cholesterol ester transfer protein (CETP) genotype (VV homozygosity for I405V) is associated with preservation of cognitive function in addition to its association with exceptional longevity. Methods: We studied Ashkenazi Jews with exceptional longevity (n ϭ 158; age 99.2 Ϯ 0.3 years) for the associations of CETP VV genotype and lipoprotein phenotype, using the Mini-Mental State Examination (MMSE). To confirm the role of CETP in a younger cohort, we studied subjects from the Einstein Aging Study (EAS) for associations between CETP VV and cognitive impairment. Results: Subjects with MMSE Ͼ 25 were twice as likely to have the CETP VV genotype (29% vs 14%, p ϭ 0.02), and those with the VV genotype were more likely (61% vs 30%, p ϭ 0.02) to have MMSE Ͼ 25. Subjects with the VV genotype had lower levels of CETP (1.73 Ϯ 0.11 vs 2.12 Ϯ 0.10 g/mL, p ϭ 0.01), higher high-density lipoprotein (HDL) levels (p ϭ 0.02), and larger lipoprotein particles (p ϭ 0.03). In the EAS cohort, an approximately fivefold increase in the VV genotype (21% vs 4%, p ϭ 0.02), higher HDL levels, and larger lipoprotein particle sizes were associated with less dementia and improved memory. Conclusions: Using two independent cohorts, we implicate the longevity CETP gene as a modulator of age-related cognitive function. A specific CETP genotype is associated with lower CETP levels and a favorable lipoprotein profile. It has not been determined whether modulation of this gene prevents age-related decline or AD.

Capital needs during the next twenty years for public wastewater treatment, piping, combined sewer overflow correction, and storm-water management are estimated to be approximately $300 billion for the USA. Financing these needs is a significant challenge, as Federal funding for the Clean Water Act has been reduced by 70% during the last twenty years. There is an urgent need for new approaches to assist states and other decision makers to prioritize wastewater maintenance and improvements. We present a methodology for performing an integrated quantitative watershed-scale goals assessment for sustaining wastewater infrastructure. We applied this methodology to ten watersheds of the Hudson-Mohawk basin in New York State, USA that together are home to more than 2.7 million people, cover 3.5 million hectares, and contain more than 36,000 km of streams. We assembled data on 183 POTWs treating approximately 1.5 million m(3) of wastewater per day. For each watershed, we analyzed eight metrics: Growth Capacity, Capacity Density, Soil Suitability, Violations, Tributary Length Impacted, Tributary Capital Cost, Volume Capital Cost, and Population Capital Cost. These metrics were integrated into three goals for watershed-scale management: Tributary Protection, Urban Development, and Urban-Rural Integration. Our results demonstrate that the methodology can be implemented using widely available data, although some verification of data is required. Furthermore, we demonstrate substantial differences in character, need, and the appropriateness of different management strategies among the ten watersheds. These results suggest that it is feasible to perform watershed-scale goals assessment to augment existing approaches to wastewater infrastructure analysis and planning.

Este artículo revisa y conecta diferentes eventos, construcciones urbanas y cartografías históricas de Nueva York en el marco cronológico definido por 1783, año de la firma del Tratado de París –que acabó con la guerra de la independencia americana–, y 1811, cuando el Plan de los Comisionados estableció el modelo urbanístico para hacer de la ciudad una metrópolis a la par de las grandes capitales europeas. Durante este breve pero intenso período –no tan estudiado como a veces se piensa– se sentaron las bases materiales e inmateriales (físicas e identitarias) del Nueva York actual. Este trabajo se centra en la activa e importante contribución que dos disciplinas, la arquitectura y la cartografía, hicieron al mencionado proceso.

This essay reviews and connects different events, urban constructions and historical cartographies concerning New York in the chronological framework defined by 1783, the year of the signing of the Treaty of Paris –ending the War of the American Revolution–, and 1811, when the Commissioners’ Plan established the urban planning model to make the city a metropolis on a par with the great European capitals. During this brief but intense period –not as studied as it is sometimes thought– the material and immaterial (the physical and identity) foundations of the current New York were laid. This work focuses on the active and important contribution that two disciplines, architecture and cartography, made to the mentioned process.

This article examines the factors that influence antipsychotic use among youth treated in public inpatient facilities. By combining data from 11 focus groups, a survey of 43 researchers and clinicians, and a chart review of 100 closed patient charts, we investigated the interplay between physicians' and staff members' perceptions of problems related to antipsychotic prescribing, their beliefs concerning optimal approaches, their actual recorded prescribing behaviors, and the discrepancies between their beliefs and their recorded practices. We discovered that antipsychotics are prescribed broadly to treat a variety of conditions, including nonpsychotic disorders among children in public inpatient facilities. Despite overall expert consensus regarding "best practices," physicians described systemic obstacles that prevent the application of these practices, and our data confirmed that best practices are not always followed. Future research should be done with this patient population and should investigate the factors that influence antipsychotic use among inpatient youth.

Studies that explore experiences of abuse among deaf or hard of hearing college students are sparse and usually focus on lifetime experiences rather than the college years. A random sample of more than 1,000 college students at a campus in Upstate New York provided the data for this study. An institute for the deaf or hard of hearing was one of the colleges at the university and provided a unique opportunity to explore experiences among this demographic. Victimization rates and experiences by auditory status-deaf and hard of hearing or hearing-were examined. Binomial regression analyses were employed and findings indicated a significant association with being deaf or hard of hearing and physical and psychological abuse at the hands of a partner. Implications for policy and future research are discussed.

By the mid-70s New York is a dying city, crippled by the burden of massive public debt, the constant rise of crime and a worsening economic recession; violence, drugs but also music, street art and poetry are everywhere. This is the city Travis wants to clean up in Martin Scorsese Taxi Driver (1976), the city Bobby and Helen look for drugs and salvation in The Panic in Needle Park by Jerry Schatzberg (1971) and the same city Reno tries to murder in Abel Ferrara’s dark but hilarious Driller Killer (1979). In this sense, New York is a beautiful death-trap inhabited by a wide range of artists taking over the vast and abandoned industrial lofts located in the Lower East Side, in which the total absence of both physical and artistic boundaries induces an incredible cross-fertilization between the arts. Torn to pieces both socially and economically, fragmented, in agony, the ruins of a once great city howl their despair through the nightmare-paintings of Joe Coleman, the masochist concerts of Alan Vega and his band Suicide, the flamboyant disguises of the New York Dolls and up to the murderous and blood-stained performances of crazy G.G Allin. This self-destructive but hilly creative use of a rundown city gives birth around 1975 to the Punk Scene and then, at the start of the 80s, to the No Wave scene, blending fast music with pop-art, poetry with violence, underground-films with pornography. At the heart of this creative outburst women’s desires, revolt and anger will play a major role in defining the shape of this artistic chaos, and their bodies will become an emotional as well as political battle field. But, while Joan Baez or Jonny Michel had poetically invented the graceful sounds and prayers of feminism in the 60s, the Lower East Side scene will call upon much more destructive forces as writer, musician, photographer and actress Lydia Lunch describes.

Authority to support a strategy of in-place management of the disposal area for another decade. The QRA methodology adopted for this first of a kind application was a scenario-based approach in the framework of the triplet definition of risk (scenarios, likelihoods, consequences). The measure of risk is the frequency of occurrence of different levels of radiation dose to humans at prescribed locations. The risk from each scenario is determined by (1) the frequency of disruptive events or natural processes that cause a release of radioactive materials from the disposal area; (2) the physical form, quantity, and radionuclide content of the material that is released during each scenario; (3) distribution, dilution, and deposition of the released materials throughout the environment surrounding the disposal area; and (4) public exposure to the distributed material and the accumulated radiation dose from that exposure. The risks of the individual scenarios are assembled into a representation of the risk from the disposal area. In addition to quantifying the total risk to the public, the analysis ranks the importance of each contributing scenario, which facilitates taking corrective actions and implementing effective risk management. Perhaps most importantly, quantification of the uncertainties is an intrinsic part of the risk results. This approach to safety analysis has demonstrated many advantages of applying QRA principles to assessing the risk of facilities involving hazardous materials.

Purpose: Younger spouses or partners have been understudied in the prolonged grief literature. The purpose of this study was to determine rates of prolonged grief in young spouses or partners and the associations between prolonged grief and personality styles (specifically, narcissistic, histrionic, and obsessive), trauma history, and the perceived meaning of the loss in the young conjugally bereaved.

Few studies of the prevalence of histologic lesions of the exocrine pancreas in dogs have been reported, and none of them systematically evaluate the localization of these lesions. The purpose of this study was to describe the anatomic localization of pancreatic inflammation, necrosis, and fibrosis in dogs presented for postmortem examination. Seventy-three pancreata from dogs presented for postmortem examination were evaluated and investigated for the presence of suppurative inflammation (SI), pancreatic necrosis (PN), and lymphocytic inflammation (LI). Sections that showed evidence of SI, PN, or LI also were evaluated for pancreatic fibrosis (F). The tendency for a preferred localization for SI, PN, and LI was evaluated by chi-square analysis. A total of 47 pancreata with histologic evidence of pancreatitis (SI, PN, or LI; F alone was not considered evidence of pancreatitis) were identified. Twenty-four (51.1%) had SI, 23 (48.9%) had PN, and 34 (72.3%) had LI. Of the 47 dogs with SI, PN, or LI, 28 (59.6%) had F. The distribution of SI, PN, and LI between the right and the left limb of the pancreas and among the 5 anatomic regions was random, based on a goodness-of-fit test. We conclude that pancreatic inflammation tends to occur in discrete areas within the pancreas rather than diffusely throughout the whole organ. These findings suggest that a single biopsy is insufficient to exclude subclinical pancreatitis and that there is no preferred site for pancreatic biopsy collection unless gross lesions are apparent.

The purpose of this essay is to demonstrate how Cox´s (1981) conceptualization of structures and historical structure could be driven to change by Campbell’s (1998) notion of constructed narratives of apparent threats behind events such as an attack in a state’s homeland soil; by analyzing both the cases of the French response to November 2015 Paris attacks and the American one after 9/11.

Objective-Staff communication has been shown to influence overall nursing home (NH) performance. However, no empirical studies have focused specifically on the impact of CNA communication on end-of-life (EOL) care processes. This study examines the relationship between CNA communication and nursing home performance in EOL care processes.

Issues are shipped in May and November. Missed issues must be reported no later than three months after shipping date or we cannot be responsible for replacements. All rights reserved. Indexed in Bibliography of the History of Art (BHA), Art Bibliographies Modern, Arts and Humanities Citation Index (ISI) and Wilson Full Text. The full text is also available through JSTOR's Arts & Sciences III Collection, www.jstor.org. Except as permitted under national laws or under the photocopy license described below, no part of this publication may be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying or otherwise, or stored in a retrieval system of any nature, without the advance written permission of the publisher.

Eleven strains of a hitherto undescribed Gram-positive, catalase-negative, facultatively anaerobic rod-shaped bacterium from human sources and medical care products were characterized by phenotypic and molecular taxonomic methods. The phenotypic properties of the bacterium were consistent with its assignment to the genus Lactobacillus but it was readily distinguished from all currently described species of this genus by its biochemical characteristics and by SDS-PAGE analysis of its cellular proteins. Comparative 16s rRNA gene sequence analysis demonstrated that the unknown bacterium was a member of rRNA group I Lactobacillus which includes Lactobacillus delbrueckii, the type species of the genus, and close relatives. Lactobacillus gasseri and Lactobacillus johnsonii were the nearest phylogenetic relatives of the unknown bacterium, but 165 rRNA sequence divergence values of ~4 % clearly showed that it represents a distinct species. Based on both phylogenetic and phenotypic evidence, it is proposed that the unknown bacterium should be classified in the genus Lactobacillus, as Lactobacillus hers sp. nov. The type strain of Lactobacillus hers is CCUG 28746T.

The Geriatrics Education for EMS (GEMS) course provides continuing education for emergency medical service (EMS) providers. This study evaluates the impact of the course on EMS providers in a rural county by performing a prospective cohort study using a pre-/post-survey design. We used the Geriatric Attitude Scale, the GEMS knowledge post-test, a class satisfaction survey, and a survey evaluating EMS providers' comfort in caring for older adults to measure the classes' impact. Eightyeight EMS providers participated. All passed the course and were very satisfied with the course. Follow up was completed on 77(80%). No significant change in attitude score was identified (p=0.09). Median comfort scores significantly increased for the following domains: communications, medical care, abuse evaluation, and falls evaluation. Providing the GEMS course to EMS providers in a rural community resulted in students achieving a pre-established level of knowledge regarding caring for older adults and an increase in their comfort level for the care of older adults. The impact of the training on patient outcomes needs to be identified.