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The author offers an introduction to the essays in a book forum on Carlin in Pastoral Aesthetics: A Theological Perspective on Principlist Bioethics (2019).

Background: Premedical students are educated in basic biological and health sciences. As a complement to traditional premedical coursework, medical school applicants are encouraged to shadow practitioners, with the hope that observation will introduce students to the culture and practice of healthcare. Yet the shadowing experience varies widely across practitioners and institutions; resources that guide students' critical reflection and structure the experience are scarce. Development: A pilot experiential learning course, Doctoring Undercover: Shadowing and the Culture of Medicine, was developed to fill this gap. The course consisted of three parts: an introduction to medical culture through the disciplines of medical sociology, history, anthropology, and bioethics; a site placement in which students applied these fields' analytical techniques to the study of medical culture and practice; and the development of an online activity guide that other premedical students may adapt to their shadowing circumstances. Implementation: Students reported that they were exposed to new disciplinary perspectives and interprofessional environments that they would not traditionally encounter. Students' contributions to the shadowing guide encouraged active learning and reflection on the dynamics of effective patient-provider relationships and shadowing experiences. Future Directions: Locally, the class may be scaled for a larger group of premedical students and incorporated into a formal pathway program for premedical students; the content will also be integrated into the clinical medicine course for first-year medical students. Online, the guide will be promoted for use by other institutions and by individuals planning extracurricular shadowing experiences; feedback will be solicited. Tools for evaluating the short- and long-term impact of the course and guide will be developed and validated. Observational and experimental studies of the course's impact should be conducted. Abbreviations: ICM: Introduction to Clinical Medicine; SCE: Selective Clinical Experiences

As President Jimmy Carter’s advisor for health issues, Peter Bourne promoted a rational and comprehensive drug strategy that combined new supply-side efforts to prevent drug use with previously established demand-side addiction treatment programs. Using a public health ethic that allowed the impact of substances on overall population health to guide drug control, Bourne advocated for marijuana decriminalization as well as increased regulations for barbiturates. A hostile political climate, a series of rumors, and pressure from both drug legalizers and prohibitionists caused Bourne to resign in disgrace in 1978. We argue that Bourne’s critics used his own public health framework to challenge him, describe the health critiques that contributed to Bourne’s resignation, and present the story of his departure as a cautionary tale for today’s drug policy reformers.

In the 1960s, as illegal drug use grew from a fringe issue to a pervasive public concern, a new industry arose to treat the addiction epidemic. Over the next five decades, the industry's leaders promised to rehabilitate the casualties of the drug culture even as incarceration rates for drug-related offenses climbed. In this history of addiction treatment, Claire D. Clark traces the political shift from the radical communitarianism of the 1960s to the conservatism of the Reagan era, uncovering the forgotten origins of today's recovery movement.Based on extensive interviews with drug-rehabilitation professionals and archival research,The Recovery Revolutionlocates the history of treatment activists' influence on the development of American drug policy. Synanon, a controversial drug-treatment program launched in California in 1958, emphasized a community-based approach to rehabilitation. Its associates helped develop the therapeutic community (TC) model, which encouraged peer confrontation as a path to recovery. As TC treatment pioneers made mutual aid profitable, the model attracted powerful supporters and spread rapidly throughout the country. The TC approach was supported as part of the Nixon administration's \"law-and-order\" policies, favored in the Reagan administration's antidrug campaigns, and remained relevant amid the turbulent drug policies of the late twentieth and early twenty-first centuries. While many contemporary critics characterize American drug policy as simply the expression of moralizing conservatism or a mask for racial oppression, Clark recounts the complicated legacy of the \"ex-addict\" activists who turned drug treatment into both a product and a political symbol that promoted the impossible dream of a drug-free America.

Objectives: Osteochondral grafting is commonly indicated for osteochondritis dissecans (OCD) of the humeral capitellum in upper extremity athletes. Use of the osteochondral allograft (OCA) as a surgical treatment is sparsely reported in the literature, but donor site morbidity is an increasing concern with the traditionally utilized knee-to-elbow autograft technique in some athletes. The purpose of this study was to evaluate return to sports and patient-reported outcomes in adolescent athletes following OCA treatment for capitellar OCD. Methods: An IRB-approved retrospective review of prospectively collected data at a single institution identified patients treated with OCA for capitellar OCD between 2012 and 2022. Inclusion criterion of a minimum of 18 months follow-up for return to sports assessment was applied. OCA transplantation with grafts harvested from the posterior apex of a fresh lateral femoral condyle allograft, or with a precut fresh osteochondral allograft dowel were included. Pre- and postoperative sport and level of sport were recorded. Preoperative and final exam, operative data, complications, and reoperation were recorded. Patient-reported outcome measures (PROMs) of Quick Disabilities of Arm, Shoulder, and Hand (QuickDASH), Timmerman–Andrews elbow subjective score, and Hospital for Special Surgery Pediatric-Functional Activity Brief Scale (HSS Pedi-FABS) were evaluated. Postoperative PROMs and range of motion were compared to preoperative values through nonparametric analysis of the Wilcoxon Signed-Rank Test. Categorical variables analyzed with the Fisher exact test, which was dependent on statistical parameters, while continuous variables were analyzed with the Mann-Whitney U test. Results: Fifteen Elbows in 13 patients treated with OCA for capitellar OCD were evaluated at an average of 2.5 years postoperatively (r = 1.5-6.3 y). The average age at treatment was 12.7 (r = 10-15) years old and 8 (62%) patients were female. The most common sports were gymnastics (54%) followed by baseball (23%). 12 (92%) of patients competed at the select/club or national/elite level. 47% (7 of 15) elbows had preoperative extension loss averaging 8° (r =4°-20°), with an average pre-operative arc of motion of 133° (r = 105°-145°). Five (33%) elbows presented with a loose body, and 4 (27%) had a concurrent radial head chondral lesion. At final follow-up, 11 of 12 (92%) patients who attempted to return to the same sport were able to do so. Ninety-one percent (10 of 11) who returned to the same sport achieved the same or higher level of competition. The average days from surgery to return to sports was 213 days (r = 134-328 days). Final Timmerman-Andrews subjective subscales reflected mild to no symptoms with an average score of 81.3. Patients reported significant improvement in QuickDASH scores (47.7 vs 11.4, p = 0.003) and had increased pre- to postoperative range of motion (130 vs 155, p = 0.008). HSS Pedi-FABS remained high at both time points with no significant difference (29 vs 22, p = 0.2). One elbow (6.7%) demonstrated symptomatic, incomplete graft incorporation and partial graft failure, requiring reoperation for osteochondroplasty at 10 months postoperative. Three additional patients had reoperation for indications not associated with graft union. Conclusions: Fresh osteochondral allograft treatment of capitellar OCD demonstrated a high rate of return to the same sport and competition level in adolescent athletes. Reliable improvements in PROMs and range of motion were achieved. The avoidance of possible knee donor-site morbidity is a significant advantage of the OCA compared to knee-to-elbow osteochondral autografts.

Racialized mass incarceration is associated with racial/ethnic disparities in HIV and other sexually transmitted infections (STIs) in the US. The purpose of this longitudinal qualitative study was to learn about the processes through which partner incarceration affects African-American women’s sexual risk. Four waves of in-depth qualitative interviews were conducted in 2010–2011 with 30 women in Atlanta, Georgia (US) who had recently incarcerated partners. Approximately half the sample misused substances at baseline. Transcripts were analyzed using grounded theory. For over half the sample ( N  = 19), partner incarceration resulted in destitution, and half of this group ( N  = 9) developed new partnerships to secure shelter or food; most misused substances. Other women ( N  = 9) initiated casual relationships to meet emotional or sexual needs. When considered with past research, these findings suggest that reducing incarceration rates among African-American men may reduce HIV/STIs among African-American women, particularly among substance-misusing women, as might rapidly linking women with recently incarcerated partners to housing and economic support and drug treatment.

This Meta-Aggregative (MA) Qualitative Evidence Synthesis (QES) identified, investigated, and critically appraised examples of ‘quality’ Teacher Critical Reflection (TCR) in recent peer-reviewed research. The key question guiding the synthesis of literature was, How is teacher critical reflection evidenced, justified, and communicated in peer-reviewed research? The synthesis detected the importance of TCR in supporting quality teacher practice in early childhood and primary school settings. The MA element guided the choice of articles and the QES identified evidence of the intricacies of teacher critical reflection. The MA QES provides insights into sustainable and purposeful TCR. Thirteen studies conducted between 2013 and 2019 met the requirements of a four-phased MA QES and were critically appraised to inform the synthesis. Recommendations derived from this review include the importance of identifying the objectives of TCR, TCR as part of teacher identity and its impact on TCR, the significant role that social collaboration plays in TCR, and the tools that support successful TCR.