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The author explores American Civil War photography by Union Army surgeon Reed Brockway Bontecou which features amputated soldiers and severed appendages. Topics discussed include the visual evaluation of the 1865 photograph "A Morning's Work," which depicts the aftermath of foot amputation, the Civil War medical practices which may be observed in the photographs captured by Bontecou, and the documentation of the amputation of Civil War soldier John Parmenter by Bontecou.

The article reports on the decision of the U.S. Supreme Court in the court case 'Immigration & Naturalization Service v. Lopez-Mendoza' in which the court held that the Fourth Amendment's exclusionary rule is inapplicable in immigration proceedings because of civil nature of those proceedings. It further discusses how exclusionary rule in both the immigration and criminal contexts has been established after the Supreme Court decision in the case.

The »problem« of cults, or new religious movements (NRMs), has been a polarising issue for centuries. The massive culture shift that took place in the 1960s saw the »problem« of cults coupled with the emergent »brainwashing« theory. This article sheds light on exactly what this so-called brainwashing theory is, providing ample evidence for its illegitimacy as an explanation as to why people join new religious movements. Tracing the history of the theory back to its inception by secret arms of both the US government and Nazi Germany, the article provides evidence for the falsity of the theory. The two concepts – brainwashing and cults – were brought together by the »anti-cult movement« (ACM) in the United States in the 1960s. After detailing these initial concepts, the article moves on to the history and development of the ACM, which accused many NRMs of using »cultic brainwashing« techniques in order to gain converts. In order to rid »victims« of these beliefs, the ACM often used violent and dangerous »deprogramming« techniques leading to the eventual downfall of the movement in 1996. Moreover, the author invites the reader to see the parallels between the actions of the alleged »cults« and those of the ACM, highlighting that the two are not so different. [ABSTRACT FROM AUTHOR]

Background: Dysregulation of the hypothalamic-pituitary-adrenal axis is hypothesized to be an important pathway linking socioeconomic position and chronic disease. Purpose: This paper tests the association between education and the diurnal rhythm of salivary cortisol. Methods: Up to eight measures of cortisol (mean of 5.38 per respondent) over 2 days were obtained from 311 respondents, aged 18-70, drawn from the 2001-2002 Chicago Community Adult Health Study. Multi-level models with linear splines were used to estimate waking level, rates of cortisol decline, and area-under-the-curve over the day, by categories of education. Results: Lower education (0-11 years) was associated with lower waking levels of cortisol, but not the rate of decline of cortisol, resulting in a higher area-under-the-curve for more educated respondents throughout the day. Conclusions: This study found evidence of lower cortisol exposure among individuals with less education and thus does not support the hypothesis that less education is associated with chronic over-exposure to cortisol. [ABSTRACT FROM AUTHOR]

Objective: To examine whether (1) student perceptions of parent behaviors explain variations in fruit and vegetable consumption, (2) self-efficacy mediates this relationship, and (3) perceived home fruit and vegetable availability moderates this relationship. Design: A cross-sectional survey. Setting: Classrooms in 3 middle schools in 2 northeast Georgia counties. Participants: 366 middle school students. The response and participation rates were 59% and 56%, respectively. Variables Measured: Perceived authoritative parenting, perceived parent control, perceived parent modeling, perceived parent support, self-efficacy, perceived fruit and vegetable availability, and fruit and vegetable consumption. Analysis: Hierarchical multiple regression; P < .05. Results: Perceived parent modeling, perceived parent support, self-efficacy, and perceived fruit and vegetable availability were significant predictors of fruit and vegetable consumption. The relationship between perceived parent support and fruit and vegetable consumption was mediated by self efficacy. The relationship between fruit and vegetable consumption and both perceived parent modeling and support was moderated by perceived fruit and vegetable availability. Conclusions and Implications: Parents appear to moderately influence middle school student fruit and vegetable consumption. Educators might focus on improving home fruit and vegetable availability and student self-efficacy, as well as parent support and modeling. The level of availability might indicate where efforts should focus for enhancing parent behaviors. [ABSTRACT FROM AUTHOR]

ABSTRACT: The Student Attitudes Toward School Safety Measures (SATSSM) instrument was developed as a new tool to assess high school students' attitudes toward school safety promotion methods. A theory-based pool of statements was scaled using Thurstone's equal appearing interval method by 186 student judges to yield a 30-item instrument. The draft version was operationalized into a 5-point, Likert scale format, using a new sample of 182 students. Exploratory factor analysis suggested three factors: mediation, surveillance, and searching methods. The SATSSM was reduced to six items for each scale with a five-item social desirability scale added, and piloted with 66 new students. Final administration of the SATSSM to 166 new students yielded scale and overall internal consistencies exceeding .80 with low interscale correlations. A simultaneously administered questionnaire measuring perceptions of school safety suggested students possessed increased awareness of school violence, but they believed improving school safety is beyond their school's control. (J Sch Health. 2002;72(3): 107-114) [ABSTRACT FROM AUTHOR]

Cultural diversity continues to expand as new families arrive in the United States. Each family brings with them the culture and customs of their home country. Cultural diversity and differences are basic in our “melting pot” society. Perhaps a more correct phrase would be a “tossed salad” society where individual differences are respected and not molded into a common “American” culture. Unfortunately, diversity remains a concern today and acceptance is still a challenge. Since our value and belief systems are formed at an early age, children's literature is a most appropriate tool to instill an attitude of acceptance and tolerance of diversity and to alleviate prejudice and injustices suffered by many cultures. Literature that focuses on cultural differences, as well as similarities, is needed for communicating acceptable values. No matter what our background, we all have much in common and much to share. The following Web sites are meant to enlighten, inspire, encourage, and be enjoyed by all who value each other-whatever their culture. [ABSTRACT FROM PUBLISHER]

Examines the access provided by academic libraries to electronic journals in the United States. Compilation of access limitations of the electronic publications; Coverage of journals by abstracting and indexing services; Search of library Web sites and catalogs to gauge access levels; Proportion of access level with institution size.

The article focuses on "Methods and Measures" workshop, which discusses emerging issues in the interface between reproduction and women's long-term health. The specific research areas addressed were urinary incontinence, innovative methods for alive methods for ensuring that local and national health policy efforts adequately address women's reproductive healthcare needs, new paradigms for modeling the female reproductive system in relation to women's health, and methods for assessing the impact of the environment on the female reproductive, system. Women are at particular risk of experiencing incontinence at younger ages at least in part because of damage associated with pregnancy. In the United States, about 40% of older women and at least 15% of younger women suffer from incontinence. The Workshop discussion highlighted the lack of awareness about this important morbidity even among women's health researchers. Participants agreed that addressing the problem of incontinence requires both political and scientific action.

Examines the character and growth of federal regulation in the U.S. during the 1970s. Potential effect of a technological change in the process of regulation on bilateral monopoly; Competitive advantage of firms from function regulation with technology-based standards; Factors which contributed to the attractiveness of function regulation during the period.

Purpose. The rationale for and steps of pharmacist credentialing and privileging are described. Summary. As pharmacy evolves to include direct patient care, health care organizations are under increasing scrutiny to verify that their pharmacists are not only licensed to practice but are capable providers of direct patient care. Credentialing is a process conducted by a health care organization to review and verify a pharmacist's credentials. Privileging authorizes a pharmacist to perform within a specified scope of practice. The steps in developing a process for pharmacist privileging consist of gathering background information from national, state, and local sources; defining the services a privileged pharmacist may provide; developing policies and procedures; and obtaining approval from the appropriate institutional bodies. An ad hoc committee convened by the American Society of Health-System Pharmacists in 2003 produced two documents, an application for privileging and a general privileging form, that may be used as templates by institutions or individuals developing a pharmacist-privileging process. Barriers to pharmacist privileging may be personal, institutional, and regulatory. Conclusion. As pharmacist roles continue to expand, there is increasing need to verify pharmacists' ability to provide direct patient care services. One way to achieve this is for institutions to develop a pharmacist-privileging process that better aligns pharmacists with the methods used to authorize scopes of practice of other types of practitioners. [ABSTRACT FROM AUTHOR]

Although an ethnically diverse workforce is believed to enhance patient care quality, Hispanics are under-represented in the nursing workforce. Recruiting and retaining Hispanic students in nursing programs is essential for greater workforce participation. This grounded theory study explored practices used by Hispanic nursing students to promote their academic success during the first semester of a baccalaureate program. Fifteen Hispanic nursing students participated in focus groups and individual interviews. Students engaged in an adaption process composed of phases related to arrival, managing, and responding to evaluations. For entering Hispanic nursing students, recognizing the weight of different assignments and adjusting time and energy accordingly were essential in the process of arriving at success. Finances, family dynamics, dealing with potential failure, and time management were significant concerns.

Objective: Controversy exists as to whether women with depression respond better to selective serotonin reuptake inhibitors (SSRIs) than men. The purpose of this report was to determine whether men and women differ in their responses to treatment with the SSRI citalopram using a large sample of real world patients from primary and psychiatric specialty care settings., Method: As part of the sequenced treatment alternatives to relieve depression (STAR *D) study, 2876 participants were treated with citalopram for up to 12-14 weeks. Baseline demographic and clinical characteristics and outcomes were gathered and compared between men and women., Results: At baseline, women were younger, had more severe depressive symptoms and were more likely to have: early onset; previous suicide attempt(s); a family history of depression, alcohol abuse or drug abuse; atypical symptom features; and one or more of several concurrent psychiatric disorders. Despite greater baseline severity and more Axis I comorbidities, women were more likely to reach remission and response with citalopram than men., Conclusions: Women have a better response to the SSRI citalopram than men, which may be due to sex-specific biological differences particularly in serotonergic systems.

Background: The excess mortality associated with depressive disorders has been most often attributed to risks for suicide but diverse findings indicate that depressive disorders also increase risks for cardiovascular (CV) mortality. Among the possible mediators is the hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity that characterizes many cases of relatively severe depressive disorder and severity is characteristic of psychotic depressive disorder., Methods: The following describes a 17-year mortality follow-up of 54 patients with Research Diagnostic Criteria (RDC) psychotic major depression or schizoaffective, mainly affective, depression. All had baseline assessments that included a 1mg dexamethasone suppression test with post-dexamethasone samples at 8 a.m., 4 p.m. and 11 p.m., Results: Regression analyses showed that both greater age and higher maximum post-dexamethasone cortisol concentrations predicted deaths due to CV causes (t=4.01, p<0.001 and t=3.03, p=0.004, respectively). The 4 who died from CV disease had a mean (SD) post-dexamethasone cortisol concentration of 18.0 (6.0)microg/dl while the mean (SD) value for the remaining 50 patients was 7.6 (6.6)microg/dl (t=3.03, df=53, p=0.004). Regression analyses showed the 11 p.m. post-dexamethasone value to be predictive of suicide (t=2.05, p=0.048)., Conclusions: Conclusions should be tentative because an earlier follow-up of a more heterogeneous, but larger, sample did not find a relationship between DST results and CV mortality, and because only 4 CV deaths occurred in the present study. HPA-axis hyperactivity is probably only one of a number of factors that link depressive disorder to CV mortality.

Background: Although epidemiologic research consistently reports greater prevalence of major depressive disorder in women, small sample sizes in many studies do not allow for full elaboration of illness characteristics. This article examines sex differences in terms of illness attributes in a cohort of 2541 outpatients from across the United States who enrolled in the Sequenced Treatment Alternatives to Relieve Depression study., Methods: Confirmatory analyses were performed in 2541 outpatients comparing men and women with regard to sociodemographic features, comorbid Axis I and Axis III conditions, and illness characteristics. Results were compared with those of our previous report on the initial population of the first 1500 individuals enrolled in Sequenced Treatment Alternatives to Relieve Depression study., Results: In both samples, nearly two thirds of the sample (62.5%) were women. Women had greater symptom severity, but men had more episodes of major depression, despite no difference in the length of illness. No differences in age of onset emerged. As in the first cohort, women showed greater rates of an anxiety disorder, bulimia, and somatoform disorder, as well as more past suicide attempts, whereas men showed more alcohol and substance abuse. Women reported more appetite, weight, hypersomnia, interpersonal sensitivity, gastrointestinal and pain complaints, and less suicidal ideation. Irritability was equally common in men and women., Conclusion: This large analysis confirmed most of the clinical features and comorbidities found to be more prevalent in the first cohort of women. In addition, this analysis corroborated previous research suggesting higher rates of atypical and anxious depression in women but refuted the notion of an "irritable depression" found in men. The report confirmed the 1.7:1 ratio for depression seen across sexes in the National Comorbidity Survey.

Objective: Antidepressant augmentation is recommended when patients do not respond to antidepressant monotherapy. However, little is know about antidepressant augmentation in clinical settings and whether these practices reflect the research evidence., Method: The authors identified 244,859 patients in Veterans Administration mental health settings with a diagnosis of depression and an antidepressant prescription during fiscal year 2002. Patients with schizophrenia, dementia, or bipolar I disorder were excluded. The authors examined the prevalence and characteristics of antidepressant augmentation during the year, defined as receiving an antidepressant and an augmenting agent (lithium, second-generation antipsychotics, combinations of antidepressants, anticonvulsants, or "other") for >/=60 consecutive days in specified doses for those without other clinical indications. Mixed-effect models were used to examine predictors of augmentation., Results: Some patients (22%) received an augmenting agent. The most commonly used agents were a second antidepressant (11%) and a second-generation antipsychotic (7%). Only 0.5% of the patients received lithium. Whites, younger patients, and those with a prior hospitalization were more likely to receive augmentation. African Americans were more likely to receive antipsychotic augmentation; whites were more likely to receive lithium., Conclusions: Antidepressant augmentation is common in clinical settings. Although lithium currently has the most research support, antipsychotic medications and a second antidepressant are the most widely used augmenting agents. Many augmenting agents are used across clinical and demographic groups. Research is needed on the relative effectiveness of these agents, along with efforts to promote the use of agents with the greatest level of research support.

Objectives: We compared the health of single mothers affected by welfare reform with the health of a nationally representative sample of women to document the prevalence of poor health as single mothers experience the effects of welfare reform., Methods: We compared risk factors and measures of health among women randomly sampled from the welfare rolls with similar data from a nationally representative sample of women., Results: Women in our welfare recipient sample had higher rates of elevated glycosylated hemoglobin (> or = 6%; prevalence ratio [PR]=4.87; 95% confidence interval [CI]=2.69, 7.04), hypertension (systole > or = 140 or diastole > or = 90; PR=2.36; 95% CI = 1.47, 3.24), high body mass index ( > or = 30; PR = 1.78; 95% CI = 1.49, 2.08), and high-density lipoprotein cholesterol (< or = 35 mg/dL; PR=1.91; 95% CI=1.17, 2.65); lower peak expiratory flow; and less physical functioning. Current smoking rates were higher (PR = 1.85; 95% CI = 1.50, 2.19) and smoking cessation rates were lower (PR=0.62; 95% CI=0.37, 0.86) than in the national sample., Conclusions: Current and former welfare recipients bear a substantial burden of illness. Further studies are necessary to interpret our findings of worsened health in the wake of welfare reform.

Objective: Follow-up studies of patients with depressive disorders have identified only a few replicable predictors of suicide and have not explored possible interactions between them. The following analysis takes advantage of a large cohort of depressed patients given detailed, structured interviews 2 decades ago., Method: The data set on which this analysis is based was collected between 1976 and 1990. Research personnel administered the Schedule for Affective Disorders and Schizophrenia to 785 adults who had major depressive disorder (Research Diagnostic Criteria) but who lacked other Axis I disorders. The current analysis used the National Death Index to determine mortality status as of 2003., Results: One in 4 of the 134 deaths were by suicide for an overall suicide rate of 4.2%. In comparison to the remaining 752 patients, the 33 who died by suicide were more likely to have been inpatients and to have had a history of suicide attempts at the time of baseline assessment. They had also expressed more hopelessness and had higher ratings of suicidal tendency. The last of these variables was the most robust by far and, when tested with other predictors in regression analyses, was the only one to retain significance (p < .0001). No interactions between predictors emerged. As in an earlier, similar study, the suicidal tendency rating was predictive of suicides that occurred after the first year of follow-up, which suggests that suicidal tendencies comprise a trait that persists across episodes., Conclusion: A global rating of suicidality appears to be the single most important predictor of eventual suicide in patients with major depressive disorder.