Disparities in Intimate Partner Violence Prenatal Counseling: Setting a Baseline for the Implementation of the Guidelines for Women's Preventive Services

Prenatal health care counseling is associated with positive health outcomes for mothers and infants. Moreover, pregnant women are considered a vulnerable population at risk of being victims of intimate partner violence. Pregnancy provides a unique opportunity to identify and refer women experiencing intimate partner violence to community resources; however, in prior research, most women reported that their prenatal care providers did not talk to them about intimate partner violence. Given the importance for providers to offer prenatal health care counseling on intimate partner violence, it is concerning that there is scant knowledge on Asian, Native Hawaiian, and other Pacific Islander mothers'' experiences in this area. The study''s objectives were (a) to determine the proportion of mothers who received prenatal health care counseling on intimate partner violence; and, (b) to examine racial differences of those who received prenatal health care counseling on intimate partner violence. Hawai‘i''s Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2004–08 were analyzed for 8,120 mothers with information on receipt of intimate partner violence prenatal health care counseling. Overall, 47.7% of mothers were counseled on intimate partner violence. Compared to Whites, Native Hawaiians, Japanese, Chinese, and Koreans were significantly less likely to report receiving prenatal health care counseling in intimate partner violence, but the opposite association was observed for Samoans. Intimate partner violence continues to be a significant problem for women, thus, this study''s findings may be used as important baseline data to measure the progress made given the implementation of the new Guidelines for Women''s Preventive Services in intimate partner violence screening and counseling.     

Recovery‐oriented policy and care systems in the UK and USA

The concept of recovery has been an influence on addicted individuals for many decades. But only in the past 15 years has the concept had a purchase in the world of public policy. In the USA, federal and state officials have promulgated policies intended to foster ‘recovery‐oriented systems of care’ and have ratified recovery‐supportive laws and regulations. Though of more recent vintage and therefore less developed, recovery policy initiatives are also being implemented in the UK. The present paper describes recovery‐oriented policy in both countries and highlights key evaluations of the recovery‐oriented interventions. [Humphreys K, Lembke A. Recovery‐oriented policy and care systems in the UK and USA. Drug Alcohol Rev 2014;33:13–18]     

The Alcoholics Anonymous Affiliation Scale: Development, Reliability, and Norms for Diverse Treated and Untreated Populations

Affiliation with Alcoholics Anonymous (AA) is an important variable to measure in many clinical and research activities. This paper reports on the development of an AA affiliation scale, and demonstrates its utility in a sample of 927 alcohol treatment seekers and 674 untreated problem drinkers. The scale is short (9 items), covers a range of AA experiences, and is internally consistent across diverse demographic groups, multiple health services settings, and treated and untreated populations. The validity of the scale is supported by the findings that treatment seekers report significantly higher AA affiliation than do untreated problem drinkers, and inpatients report higher affiliation than outpatients. Potential clinical and research applications of the scale are proposed.     

Pediatric Healthcare Professionals’ Views on Autism Spectrum Disorder Screening at 12–18 Months

This study explored North Carolina pediatric healthcare professional’s (PHP) perceptions of screening 12–18 month old infants for Autism Spectrum Disorder (ASD). Eight focus groups (66 PHPs) were conducted across practice settings. The purpose was to explore PHP’s perspectives to: inform development of ASD screening tools and ultimately impact their use in PHP settings. PHPs reported concerns, barriers, and the need for research to support early ASD screening. Additionally, they expressed the need for: (a) clear “red flags” of ASD for 12–18 month olds; (b) socioculturally sensitive and effective screening tools; (c) effective early interventions; (d) systems to handle potential increases in referrals; and (e) continuing education. PHPs also demonstrated preferences about screening tool characteristics and processes for enhancing screening efforts.     

Preliminary Characterization of a Polycaprolactone-SurgihoneyRO Electrospun Mesh for Skin Tissue Engineering

Skin is a hierarchical and multi-cellular organ exposed to the external environment with a key protective and regulatory role. Wounds caused by disease and trauma can lead to a loss of function, which can be debilitating and even cause death. Accelerating the natural skin healing process and minimizing the risk of infection is a clinical challenge. Electrospinning is a key technology in the development of wound dressings and skin substitutes as it enables extracellular matrix-mimicking fibrous structures and delivery of bioactive materials. Honey is a promising biomaterial for use in skin tissue engineering applications and has antimicrobial properties and potential tissue regenerative properties. This preliminary study investigates a solution electrospun composite nanofibrous mesh based on polycaprolactone and a medical grade honey, SurgihoneyRO. The processing conditions were optimized and assessed by scanning electron microscopy to fabricate meshes with uniform fiber diameters and minimal presence of beads. The chemistry of the composite meshes was examined using Fourier transform infrared spectroscopy and X-ray photon spectroscopy showing incorporation of honey into the polymer matrix. Meshes incorporating honey had lower mechanical properties due to lower polymer content but were more hydrophilic, resulting in an increase in swelling and an accelerated degradation profile. The biocompatibility of the meshes was assessed using human dermal fibroblasts and adipose-derived stem cells, which showed comparable or higher cell metabolic activity and viability for SurgihoneyRO-containing meshes compared to polycaprolactone only meshes. The meshes showed no antibacterial properties in a disk diffusion test due to a lack of hydrogen peroxide production and release. The developed polycaprolactone-honey nanofibrous meshes have potential for use in skin applications.     

Mucoepidermoid carcinoma of the larynx in a child

Laryngeal carcinoma in childhood is rare and most commonly classified as squamous cell carcinoma. Although mucoepidermoid carcinoma of the larynx has been noted in adults, it has not previously been reported in a child. A 13-year-old boy presented to our department with an epiglottic mass which was determined histologically to be mucoepidermoid carcinoma. A total epiglottectomy was performed and one year postoperatively the child is without disease.     

Osteomyelitis of the cervical spine presenting as a neurenteric cyst

A healthy 3-week-old baby girl developed a cyanotic spell that required intubation and ventilation. During part of her initial emergency examination and treatment, a neck mass was felt, and a positive blood culture grew staphylococcus aureus. She was transferred to the ICU, and was ventilated and treated with intravenous cloxacillin. Bronchoscopy showed a paralyzed left cord. Computerized tomography (CT) scan of her neck showed a midline mediastinal mass (behind the compressed trachea and esophagus), that extended from C7 to the carina. Because of the suspicion of an abnormal C7 vertebral body, diagnosis of a neurenteric cyst was made, and a myelogram showed a complete block at the T1 level and an absent C7 vertebral body. There were no neurologic signs. Her right knee then became red and swollen, and x-rays showed a lytic area in the distal femur. This knee was explored under general anesthesia, and an osteomyelitis found and drained. Several days later, a barium swallow showed the mediastinal mass pushing the esophagus to the left, but several more cervical vertebrae were "missing," and the diagnosis of osteomyelitis of the cervical spine was confirmed. The mediastinal staphylococcal abscess was then drained through the neck. Follow-up has been unremarkable over the last 4 years.