Building humane communities respectful of children: the significance of the convention on the rights of the child.

The greatest promise of international human rights law is in stimulating thoughtful self-examination by those who strive to do what is right. Perhaps more than any other instrument, the Convention on the Rights of the Child (CRC; 1989) offers the opportunity to use a global moral consensus to transform life at the neighborhood level in order to promote "the full and harmonious development of..

Treating children like people: a framework for research and advocacy.

Issues in child policy are often obscured by symbolic debates about the nature of child development and family life. There is a need for greater care in the identification of the interests at stake and articulation of the normative foundation for various policies and programs. The Convention on the Rights of the Child carries an implicit rights-focused agenda for social science research.

A temporal constraint structure for extracting temporal information from clinical narrative.

Introduction: Time is an essential element in medical data and knowledge which is intrinsically connected with medical reasoning tasks. Many temporal reasoning mechanisms use constraint-based approaches. Our previous research demonstrates that electronic discharge summaries can be modeled as a simple temporal problem (STP).

Interpretation of 99mTc sestamibi parathyroid SPECT scan is improved when read by the surgeon and nuclear medicine physician together.

Objective: Parathyroid gland localization and lateralization are important before surgery, particularly for minimally invasive parathyroidectomy (MIP) and recurrent hyperparathyroidism. We hypothesized that readings of Tc sestamibi scans with single photon emission computed tomography (SPECT) by a surgeon and nuclear medicine physician together (NMP+S) compared to a nuclear medicine physician alone (NMP alone) might affect scan interpretation accuracy.

Methods: Between May 1999 and December 2002, 127 hyperparathyroid patients had preoperative localization with sestamibi SPECT.

Surgical management of bile duct injuries sustained during laparoscopic cholecystectomy: perioperative results in 200 patients.

Objective: A single institution retrospective analysis of 200 patients with major bile duct injuries was completed. Three patients died without surgery due to uncontrolled sepsis. One hundred seventy-five patients underwent surgical repair, with a 1.

Automated detection of adverse events using natural language processing of discharge summaries.

Objective: To determine whether natural language processing (NLP) can effectively detect adverse events defined in the New York Patient Occurrence Reporting and Tracking System (NYPORTS) using discharge summaries.

Design: An adverse event detection system for discharge summaries using the NLP system MedLEE was constructed to identify 45 NYPORTS event types. The system was first applied to a random sample of 1,000 manually reviewed charts.

Effect of calcium channel blockers on the sensitivity of preoperative 99mTc-MIBI SPECT for hyperparathyroidism.

Background: Technetium 99m ( 99m Tc)-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) is frequently used in the evaluation of patients with hyperparathyroidism. Calcium channel blockers (CACBs) may affect 99m Tc-MIBI uptake by parathyroid cells. This study examines the effect of CACB therapy on the sensitivity of 99m Tc-MIBI SPECT localization for hyperparathyroidism.

Percutaneous management of bile duct strictures and injuries associated with laparoscopic cholecystectomy: a decade of experience.

Background: The 1990s were associated with a dramatic increase in bile duct injuries with the widespread use of laparoscopic cholecystectomy (LC). Interventional radiology has an integral role in diagnosing and managing these injuries. Definitive percutaneous management with balloon dilatation might be possible in select patients with intact biliary-enteric continuity, but longterm data are limited.

Mental health and social justice: a vision for the 21st century.

If the American Orthopsychiatric Association is to prosper, it must follow a vision grounded in its historic concern with social justice, relevant to contemporary concerns, and pursued through the expertise of its members. Such a vision may lie in a 3-part agenda: (a) a psychologically-minded analysis of, and advocacy for, human rights: (b) attention to mental health concerns in the work of the Washington Group of international agencies; and (c) advocacy for access by disadvantaged people with mental health problems to a broad array of services and to a climate of respect.

Chronic neglect of family violence: more than a decade of reports to guide US policy.

For more than a decade, several boards and committees have reviewed the state of policy, research, and services on child maltreatment and other forms of family violence in the US. Although these efforts have resulted in a redefinition of the tasks involved in protecting people within their homes, this new conceptualization has yet to have a substantial effect on policy, research, and services. Some positive steps have been taken, but most are still modest in scope.

Major bile duct injuries associated with laparoscopic cholecystectomy: effect of surgical repair on quality of life.

Objective: To assess the quality of life (QOL) of patients after surgical reconstruction of a major bile duct injury from laparoscopic cholecystectomy (LC).

Summary Background Data: The incidence of bile duct injuries has increased dramatically since the introduction and widespread use of LC. Previous reports show that at long-term follow-up, most patients surgically repaired will have a successful outcome as measured by standard clinical parameters.

Children's law: toward a new realism.

The realist approach that has dominated American jurisprudence has long had especially great acceptance in regard to children's issues. Ironically, however, decision making on such topics has seemed to be particularly unlikely to be informed by careful assessments of social reality. Symbolism has prevailed over pragmatism.

Postoperative bile duct strictures: management and outcome in the 1990s.

Objective: To describe the management and outcome after surgical reconstruction of 156 patients with postoperative bile duct strictures managed in the 1990s.

Summary Background Data: The management of postoperative bile duct strictures and major bile duct injuries remains a challenge for even the most skilled biliary tract surgeon. The 1990s saw a dramatic increase in the incidence of bile duct strictures and injuries from the introduction and widespread use of laparoscopic cholecystectomy.

Patterns and correlates of gun ownership among nonmetropolitan and rural middle school students.

Examined prevalence of gun ownership and the links among gun ownership, reasons for gun ownership, and antisocial behavior in a sample of nonmetropolitan and rural middle school students. Participants completed the Questionnaire for Students (Olweus, 1995) and included 6,263 students from 36 elementary and middle schools, of whom most were African American (range = 46%-95% per school). Reasons for gun ownership were strongly associated with rates of antisocial behavior.

CpG oligodeoxynucleotides and interleukin-12 improve the efficacy of Mycobacterium bovis BCG vaccination in mice challenged with M. tuberculosis.

Mycobacterium bovis bacillus Calmette-Guérin (BCG) is the only vaccine approved for prevention of tuberculosis. It has been postulated that serial passage of BCG over the years may have resulted in attenuation of its effectiveness. Because interleukin-12 (IL-12) and oligodeoxynucleotides (ODN) containing cytidine phosphate guanosine (CpG) motifs have been shown to enhance Th1 responses in vivo, they were chosen as adjuvants to increase the effectiveness of BCG vaccination.

Multisystemic therapy with violent and chronic juvenile offenders and their families: the role of treatment fidelity in successful dissemination.

The effects of multisystemic therapy (MST) in treating violent and chronic juvenile offenders and their families in the absence of ongoing treatment fidelity checks were examined. Across 2 public sector mental health sites, 155 youths and their families were randomly assigned to MST versus usual juvenile justice services. Although MST improved adolescent symptomology at posttreatment and decreased incarceration by 47% at a 1.

Double-blind study of pulsing magnetic field effects on multiple sclerosis.

We performed a double-blind study to measure the clinical and subclinical effects of an alternative medicine magnetic device on disease activity in multiple sclerosis (MS). The MS patients were exposed to a magnetic pulsing device (Enermed) where the frequency of the magnetic pulse was in the 4-13 Hz range (50-100 milliGauss). A total of 30 MS patients wore the device on preselected sites between 10 and 24 hours a day for 2 months.

The child's right to a family environment. Why children's rights and family values are compatible.

Critics of the Convention on the Rights of the Child (U.N. General Assembly, 1989) have lobbied against its ratification on the grounds that its impact in the United States would be antifamily.

Children in war and its aftermath: mental health issues in the development of international law.

Children now experience war as they never have in the past. This article presents clinical impressions of children from war zones and suggests interventions that might ameliorate the horrors of war for some of these children. It also describes the evolving framework in international law (i.

Doing justice and doing good: conflicts for mental health professionals.

The primary role of mental health professionals in cases of child abuse should be to treat the victims and the offenders. Currently, however, mental health professionals are often involved in the investigation and adjudication of child sexual abuse claims. This article discusses the conceptual and practical conflicts this involvement creates with the mental health professional's therapeutic role.

Assessing violent offending in serious juvenile offenders.

The convergent validity of the two most frequently used methods for assessing violent offending in juveniles (i.e., self-reports and arrests) was evaluated.

Family preservation using multisystemic therapy: an effective alternative to incarcerating serious juvenile offenders.

Multisystemic therapy (MST) delivered through a community mental health center was compared with usual services delivered by a Department of Youth Services in the treatment of 84 serious juvenile offenders and their multiproblem families. Offenders were assigned randomly to treatment conditions. Pretreatment and posttreatment assessment batteries evaluating family relations, peer relations, symptomatology, social competence, and self-reported delinquency were completed by the youth and a parent, and archival records were searched at 59 weeks postreferral to obtain data on rearrest and incarceration.