Administration of the Michigan Alcoholism Screening Text (MAST) at a Student Health Service

Abstract

“Blood Glucose Control and the Evolution of Diabetic Retinopathy and Albuminuria: A Preliminary Multicenter Trial,” The Kroc Collaborative Study Group. We conducted a prospective multicenter randomized trial to determine both the feasibility of maintaining blood glucose control at differing levels and the effect of improved control on diabetic microangiopathy and albuminuria. Seventy patients with diabetes (low C-peptide level) with nonproliferative retinopathy were randomly assigned to continuous subcutaneous insulin infusion or unchanged conventional injection treatment. At entry, both groups had similar demographic, clinical, and glycemic characteristics. Over the succeeding eight months, mean 24-hour glucose concentrations (175 ± 9 mg per deciliter) and glycosylated hemoglobin levels (10.0 ± 0.3%) remained elevated during conventional treatment but fell to nearly normal levels (117 ± 6 mg per deciliter and 8.1 ± 0.2%, respectively) with continuous insulin infusion. The frequency of biochemical hypoglycemia (< 40 mg of blood glucose per deciliter) was similar in both groups, but ketoacidosis occurred only during continuous infusion. The level of retinopathy, assessed from photographs, progressed in both groups. Continuous infusion was associated with slightly more deterioration, mainly because of the appearance of soft exudates and intraretinal microvascular abnormalities. In contrast, elevated albumin-excretion rates fell during continuous infusion but not during conventional treatment. We conclude that maintenance of differing levels of blood glucose is feasible in a multicenter trial and that a nearly normal blood glucose level for eight months does not retard progression of, and may initially worsen, established retinopathy. These preliminary observations indicate the need for longer trials (particularly of primary prevention). (New England Journal of Medicine 1984;311:365-72.)     

Paternity leave implementation in Switzerland: a challenge to gendered representations and practices of fatherhood?

Transition to parenthood in Switzerland takes place in a particularly gendered institutional context. It is the only European country where men do not have access to any kind of statutory parental or paternity leaves. This study empirically investigates the extent to which institutional change – through paternity leave implementation at the company level – challenges gendered representations and practices of fatherhood. The study draws on a mixed methods case study conducted in a public administration which implemented a one-month paid paternity leave. Using register data about leave recipients (N = 95), we adopt a longitudinal and typological approach of leave uptake patterns by means of sequence and cluster analyses. In-depth interviews conducted with recipient fathers and managers working for the company (n = 30) enable an analysis of the implementation process and the meanings associated with paternity leave and fatherhood. Results show that paternity leave implementation challenged, in a limited way, gendered representations and practices of fatherhood. Fatherhood was made more visible within the company, but workplace characteristics and informal norms influenced fathers' leave uptake. Overall, motherhood and fatherhood were associated with different and specialized responsibilities. Fathers mainly had a secondary and temporary role with the newborn, while mothers were the central and taken-for-granted parent.     

Short-distance pollen dispersal by bats in an urban setting: monitoring the movement of a vertebrate pollinator through fluorescent dyes

Pollen dispersal in tropical seed plants is established mainly by biotic vectors, both in intact and fragmented environments. In urban landscapes, the segregation of natural remnants by an artificial matrix can reduce pollinator foraging efficiency. It is unknown how nectarivorous bats, regarded as long-distance pollen dispersers, respond to such habitat structure combined with city-related factors. Here, we investigated the pollen dispersal pattern between spatially segregated individuals of the bat-pollinated Bignoniaceae Crescentia cujete within an urban environment. From 2015 to 2017, we assessed their spatiotemporal structure, breeding system and annual fruit set in order to relate these factors to the bat activity in the region. We employed fluorescent dyes as pollen analogues to infer the role of bats in pollen flow. Adding to the low density of individuals, we found a low daily flower emission and low flowering synchrony (S?=?0,092), all of which are traits that favor outcrossing. Individuals were distributed in two distant groups (>600 m), with no occurrence of dye flow between them. In contrast, flow within the same individual was intense, which points toward bats’ territorial behavior. C. cujete is self-compatible, but not autogamous; therefore, despite few outcross events, bats could be ensuring the plant’s year-round fruit production mainly through self-pollination. Our findings show restricted bat foraging extent, which affects overall pollen dispersal distance and population connectivity. These results can be extrapolated to natural metapopulations inserted in an urban matrix and serve as a groundwork for studying directly the effect of city-related factors on pollinator behavior.

     

A Child Wanted by Two,Conceived by Several: Lesbian-Parent Families Negotiating Procreation with a Known Donor

This article presents procreation agreement negotiations and the role played by men taking part as known donors in the parental project of lesbian mothers in the province of Quebec, Canada. Thirty-six individuals were interviewed: 10 female couples, 11 donors, and 5 of the donors’ life partners. The results show that the donors’ contribution takes place within a deliberative process during which the adults involved discuss 5 elements, namely (a) the procreation method selected, (b) the issue of future donations, (c) the forms of address and the role of the donor in the life of the children issuing from his donations, (d) the possible involvement of the donor's loved ones in the life of the lesbian-parent family, and (e) responses to various scenarios that might arise in the future. The negotiation also addresses concerns that those involved might have regarding the children's needs, resulting in a complex web of interpersonal relationships. Our findings show that dialogue is the key unifying factor, ensuring that everyone is in agreement and that the donor's role with respect to the child is in line with the expectations of everyone involved.     

Association for Lesbian,Gay, Bisexual,and Transgender Issues in Counseling’s Best Practices in Addressing Conscience Clause Legislation in Counselor Education and Supervision

The amount of various, state-level legislation allowing the denial of counseling services to individuals with values that conflict with those of the professional counselor continues to increase. Such laws are in direct conflict with the values, principles, and ethical standards of the counseling profession. These “conscience clause” legislations are of concern due to the ability of the counseling profession to safeguard and protect the welfare of clients seeking counseling services. Potently, however, much of the focus of conscience clause legislation centers around the legal sanctioning of bias and refusal to provide services to affectional and gender minority clients, and the intersection of sexual/affectional orientation to spiritual and religious values. Provided is a review of these laws and the way they clash with the counseling profession. To assist profession counselors in navigating appropriate ethical behavior, specific counseling-appropriate and lesbian, gay, bisexual, trans, and queer affirming recommendations are provided. Each layer of professional counseling, direct work with clients, supervision, and counselor education, is addressed.     

Modern times: an ethnographic study on the quality of life of people with a high support need in a Flemish residential facility

This ethnographic study shows the impact of the care system on clients' and staff's life experiences, with the clear distance between these two groups as one of the core issues. Together with a dominant care approach and a well established but subtile system of control, it makes them function in systems that are characterized by an oppressing care culture. Learned helplessness prevents both groups of acting upon quality of life outcomes. The idea of supporting a life of good quality through merely improving these traditional care systems should therefore be considered with caution, and real alternatives should be considered to open this barrier of the oppressing care culture.     

Beyond the asylum-applications growth. The limits of the Spanish refugee reception program

Based on two extended qualitative research projects conducted between 2017 and 2022, this paper analyses the refugee reception programme (RP) in Spain, which is managed both by the central state and some specialised social organisations. This cross-sectoral RP presents notable and enduring problems, which have deepened since the increase in asylum applications during the so-called European refugee crisis in 2015. This paper affirms that, although this increase in asylum seekers represents a serious challenge, the persistent shortcomings of the RP are better explained by a set of structural factors related to (1) the restrictive institutional model of asylum and immigration policy, (2) the lack of development of the RP, its dispersal policy and its social intervention design, (3) the lack of multilevel governance between the State and the municipalities and regional administration and (4) the current neoliberal and nativist policies.