Treatment of incarcerated, sexually-abused adolescent females: an outcome study

This study examined the psychosocial functioning of 100 adolescent females (ages 12-17) sentenced to secure care in a southeastern state and the impact of gender-specific, cognitive-behavioral therapy (CBT) intervention on the psychosocial functioning of subjects who reported a history of sexual abuse. The Multidimensional Adolescent Assessment Scale (MAAS) was used to assess psychosocial functioning. Pre-test scores on the MAAS revealed significantly higher scores on 12 of 16 dimensions of psychosocial functioning and higher rates of serious criminal behavior for youth who subsequently disclosed sexual abuse histories as compared to those without such histories. At post-test, statistically significant improvements in psychosocial functioning were observed on 14 of 16 MAAS subscales for those who received the CBT intervention. Thus, incarcerated female adolescents who reported a history of sexual abuse demonstrated more impairment in their functioning as compared to those without a reported history of sexual abuse and responded positively to gender-specific, CBT-based intervention.     

Gamma-secretase--intramembrane protease with a complex

Gamma-secretase catalyzes intramembrane proteolysis of the amyloid beta protein precursor, a process closely linked to the development of Alzheimer's disease. This protease also cleaves the transmembrane domain of the Notch receptor as part of a signaling pathway that is essential for proper embryonic development. Recent findings suggest that gamma-secretase is a complex of at least four integral membrane proteins: presenilin, nicastrin, Aph-1, and Pen-2. Assembly of these four components apparently leads to autocleavage of presenilin into two subunits that together compose the intramembranous active site of gamma-secretase. Understanding the mechanism of this unusual enzyme is important, as it is both a key therapeutic target and a founding member of a newly discovered class of intramembrane-cleaving proteases.     

Complying with voluntary codes of conduct: Corporate strategies for the Valdez Principles

The Valdez Principles is the latest of a series of voluntary codes of conduct that have been enunciated by various advocacy groups to guide the behavior of business enterprises. These principles provide guidelines on corporate conduct towards the environment and present a corporation with critical choices. This study suggests alternative strategies that firms may adopt to cope with this new code. Experience with the Sullivan and MacBride Principles is analyzed to serve as the basis to predict corporate response to the Valdez Principles.     

Scenarios in Europe—Who uses them and why?

The authors of this article describe a study of European companies the aim of which was to review the extent of multiple scenario analysis in company planning. They describe the differences in planning between users and non-users of the system, and analyse the benefits and drawbacks of using the system.     

Physician-nurse migration to the United States: regional and health status origins in relation to legislation and policy

This article examines the origins of physicians and nurses who were admitted as permanent immigrants to the US from 1962-1979. Data are mainly from the Immigration and Naturalization Service. Countries used in the developmental analysis are only those whose population was estimated at 1 million or more as of mid-1979, encompassing 99% of the physicians and 97% of the nurses. Life expectancy at birth is the criterion used to differentiate origin countries by developmental dimension of health status. During the study period, health workers constituted about 30% of immigrants admitted to the US; of these, nurses and physicians constituted 72-82% throughout the study period. The period 1962-1979 has 4 distinct phases, marked by important legislative and/or policy changes; 1) 1962-1965, when the McCarran-Walter Act prevailed; 2) ending in 1968, the 2nd phase covers the transition mandated under the 1965 Immigration Act, which encouraged physician immigration; 3) the 3rd phase, 1969-1976, covers the transition to the 1976 Immigration and Nationality Act amendments; and 4) the 4th stage is 1977-1979. Results show that 1) under the McCarran-Walter Act, North America became the dominant physician source; 2) from 1966-1968, Asia attained dominance as the physician source and became even more predominant after 1968; 3) North America produced relatively few physicians in the early 1970s; 4) Europe produced substantially fewer physicians in the 1970s than in the 1960s; 5) South America, Africa, and Oceania were the lowest contributors of physicians; 6) during the McCarran-Walter years, North America and Europe produced almost 90% of nurses admitted into the US; 7) the 1965 Immigration Act and its aftermath resulted in Asia becoming the dominant source of nurses; 8) prior to the 1965 Immigration Act, Canada generated 20% of the aggregate number of physicians; 9) the Philippines surpassed Canada during the transition and India led after the transition; and 10) Canada supplied 30% of the nurses up through the transition, with the Philippines in the lead 1969-1979. Low health status countries were a relatively minor nurse source. Health status at the origin was a far less significant determinant of physician immigration than that of nurses. English language high and low health status country groups produced substantially more physician and nurse immigrants that their corresponding non-English language counterparts. The US attracted more physicians and nurses from less developed countries than more developed countries after 1968.     

International law and human rights: trends concerning international migrants and refugees

Not with standing human rights linkages, migrants and refugees are often on the periphery of effective international protection. State sovereignty and self-regarding notions of community are used to deny or dilute substantive and procedural guarantees. Recently, even non- discrimination as a fundamental principle has been questioned, as has the system of refugee protection. This article located both migrants and refugees squarely within the human rights context, contrasting both inalienable rights with the demands of sovereignty, and juxtaposing the 2 in a context of existing and developing international standards. Migration and refugee flows will go on, and the developed world, in particular, must address the consequences - legal, humanitarian, socioeconomic, and cultural. Racism and institutional denials of basic rights daily challenge the common interest. This article shows how the law must evolve, responding coherently to contemporary problems, if the structure of rights and freedoms is to be maintained.     

Update on medications for the treatment of anxiety

It is interesting to note that antidepressants are widely represented in the medications used to treat the anxiety disorders. This has led to speculation about the role of depression, particularly subclinical forms being manifested as anxiety disorders. The specificity of diagnostic categories suggests that, at least for the moment, medications have a very specific and circumscribed role in the treatment of anxiety. This suggests that the difficulties of many anxious patients are not effectively treated with medication or that medication has only a short-term role at best. The next column will review health problems associated with psychotropic treatments for anxiety and discuss strategies for creating a "wedge," ie, introducing adjunct learning experiences along the anxiety gradient in conjunction with pharmacotherapy.     

Selecting a family therapy model: the role of personality attributes in eclectic practice*

The expanding knowledge and skill bases within the interdisciplinary family therapy profession pose a significant challenge for evolving practitioners, at whatever stage along the professional development process they find themselves. This challenge raises a basic question regarding whether there are any constraining forces to the level of eclecticism in practice towards which one can aspire. This paper empirically explores the role played by the personality attributes of the family therapist in facilitating and/or inhibiting one's adherence to a variety of approaches to family practice.